Pelvic Inflammatory Disease Presenting as Acute Peritonitis in an Australian Rural Center

A 38-year-old female presented to a rural emergency department with peritonitis, severe right upper quadrant pain, and abdominal distension. Blood tests revealed elevated inflammatory markers, and imaging was inconclusive for acute cholecystitis. The patient was complaining of severe pain with persistent tachycardia after adequate fluid resuscitation. Exploratory laparotomy was performed which revealed the diagnosis of pelvic inflammatory disease caused by Neisseria gonorrhoeae .