Which of the following is NOT a typical feature of pelvic inflammatory disease?

• A. Lower abdominal pain
• B. Vaginal discharge
• C. Fever
• D. Severe upper quadrant abdominal pain

Answer: (D)

Pelvic inflammatory disease is an ascending infection of the upper female genital tract, and its typical picture centers on lower abdominal or pelvic symptoms rather than upper abdominal ones. Patients commonly have lower abdominal/pelvic pain, fever, and vaginal discharge, with exam findings such as cervical motion tenderness and adnexal tenderness. Severe upper quadrant (right upper quadrant) abdominal pain is not a standard feature of PID; if RUQ pain is present, it points to other causes like gallbladder disease or hepatitis, or a rare PID complication called perihepatitis (Fitz-Hugh–Curtis syndrome) rather than a hallmark of the disease itself. So the feature described as severe upper quadrant pain isn’t a typical PID finding.