Patients with acute PID usually present with mild to severe lower abdominal pain or discomfort. Other common symptoms are vaginal discharge, dysuria, deep dyspareunia, pain on defaecation, fever with or without chills and menstrual irregularities.

A patient with chronic PID may have symptoms such as chronic lower abdominal pain, dyspareunia, menstrual irregularities or infertility.

Some patients with pelvic inflammatory disease may have no significant symptoms or signs. Practitioners must be alert to the possibility of PID in patients at risk even in the absence of clinical signs and laboratory evidence of infection.

Examination may reveal lower abdominal tenderness, unilateral or bilateral adnexal tenderness with or without a mass, cervical motion tenderness (elicited by gentle movement of the cervix), purulent vaginal discharge and fever. In some cases clinical examination is negative.

Complications include pyosalpinx, tubo-ovarian abscess and peri-hepatitis (Fitz-Hugh-Curtis syndrome). PID is a major cause of tubal damage leading to ectopic pregnancy and infertility.
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