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Histopathology of Chlamydia trachomatis salpingitis after primary and repeated reinfections in the monkey subcutaneous pocket model.

Monkeys with subcutaneously autotransplanted salpingeal fimbrial tissues were subjected to primary and repeated infections with Chlamydia trachomatis. The inflammatory response after primary inoculation was characterized by infiltration with polymorphonuclear leucocytes in the acute phase and mononuclear cells in the chronic phase. However, the inflammatory response after repeated infections was dominated by a mononuclear cell infiltration with a conspicuous absence of the initial phase of polymorphonuclear leucocyte infiltration. The remarkable findings of repeated infections were plasma cell infiltration, lymphoid follicle formation, and increased fibroblast activity resulting in extensive fibrosis. These findings are similar to those described for monkeys inoculated directly into the oviducts with C. trachomatis and support our original hypothesis that, after chlamydial infection, the tissue damage is provoked by immune-mediated mechanisms.

Animals↗

The combination of pregnancy and acute salpingitis in a case of uterus didelphys.

A pregnant woman, with a uterus didelphys, developed abdominal pain. Laparotomy disclosed a severe infection of the tube of the non-pregnant horn. The diagnosis of acute salpingitis should be considered when a patient with a uterus didelphys develops unilateral abdominal pain. The present case seems to prove the blocking effect of an intrauterine pregnancy on an ascending infection.

Acute Disease↗

Salpingitis caused by Chlamydia trachomatis and its significance for infertility.

Between July and November 1991, 32 women (mean age 24.8 years) were examined laparoscopically in our department for suspected tubal sterility. All women had smears taken from cervix, vagina, and urethra, and all were negative regarding an infection with Chlamydia trachomatis. All women had open fallopian tubes, however, with inflammatory changes that varied in degree. Fifteen women reported pains and were classified as PID (pelvis inflammatory disease)-positive, as compared to the PID-negative group of 17 women without pain. In the group of the 15 PID-positive women, we could detect Chlamydia trachomatis in the form of salpingitis in 11 cases in the direct demonstration of the infectious agent. IgA antibodies were detected in the serum of all of these women, in 12 of them IgA + IgG antibodies. In the group of the 17 PID-negative women, three were positive in the direct detection of the infectious agent, and IgA and/or IgG antibodies were detected in five cases. 38% of the women in the PID-positive group and 68% in the PID-negative group conceived within a period of one year after having completed a treatment with antibiotics.

Adult↗

[A case of Enterobius vermicularis salpingitis].

Enterobius vermicularis peritonitis due to intestinal infection is a common entity described in the literature. We report here an unusual case of unilateral salpingitis associated with the parasite migration through the genital tract.

Adult↗

Isolation of Chlamydia in acute salpingitis.

In 22 patients with acute salpingitis, verified by laparoscopy, samples for attempted isolation of bacteria, Mycoplasma and Chlamydia were drawn from aspirates and cervical smears. CF-antibodies to Chlamydia were measured to acute and convalescent phase sera. Anaerobic bacteria were isolated from tubal secretions in two patients and Mycoplasmas in one patient. In two patients Chlamydia were recovered from the Fallopian tube. The serological investigation indicated Chlamydia infection in 6 patients.

Acute Disease↗

Haemophilus influenzae as a cause of salpingitis.

A case is reported of acute unilateral salpingitis, the cause of which was Haemophilus influenzae cultured from a pus sample taken from the infected Fallopian tube during laparotomy. The significance of the findings is discussed with reference to the literature.

Acute Disease↗

[Acute salpingitis].

The incidence of acute salpingitis which are only one aspect of pelvic inflammatory disease has decreased during the last 20 years and more and more patients have mild symptoms. Consequences of this evolution are uncertainty for the diagnosis without laparoscopic proof of the pelvic inflammatory disease, ambulatory treatment with inappropriate regimen increasing the risk of chronical disease and long term sequelae. So laparoscopy must remain a standard in diagnosis and treatment especially in young childless women. Follow up of the medical treatment is necessary to assess its effectiveness and its compliance, to treat the sexual partner, and to provide informations about preventive measures to avoid relaps.

Chlamydia Infections↗

[Mature intraligamentary pregnancy with florid salpingitis tuberculosa (author's transl)].

Reported is a case of a 32 year old para II where an intraligamentary extrauterine pregnancy was terminated by caesarean section at term following spontaneous rupture of the amniotic sack. The newborn male weighed 3600 g, there were no malformations. There was a transient phase of asphyxia. Histologic examination of the placenta, that had developed in the mesosalpinx, the Fallopian tube and the uterus that had been amputated supracervically, showed to our surprise a florid caseating tuberculosis of the mucosa of uterus and Fallopian tube and also in a circumscribed area of the basal plate. After an initial uneventful course the newborn developed clinical manifestations of connatal tuberculosis on the 16th day of life. Whereas the mother died a few days after delivery, the baby survived the infection, this certainly was due in large part to the prophylactic tuberculostatic treatment that had been initiated immediately after the diagnosis of tuberculosis was made on account of histology. The case of an extrauterine pregnancy at term reported here differs from most of the previous reports by a) the site of the pregnancy, b) the development of a mature living newborn without malformations and in respect to b) it differs from all previous publications by the existing active caseating tuberculous salpingitis and endometritis of the mother, and the connatal tuberculosis of the newborn with its successful treatment.

Adult↗

[Chlamydia infection and salpingitis].

Chlamydia trachomatis is the most prevalent etiologic agent in women with uncomplicated salpingitis. This presentation reviews the current aspects of etiology, diagnosis, therapy, prevention and complications of this disease. The other clinical manifestations of chlamydial infection are also discussed.

Chlamydia Infections↗

Enterobius vermicularis salpingitis: a distant episode from precipitating appendicitis.

Chronic pelvic inflammatory disease is a common gynecologic diagnosis in women with chronic pelvic pain. When standard antimicrobial therapy does not improve the clinical status, uncommon diagnoses such as Enterobius vermicularis should be considered. In this case, E vermicularis presented as acute and chronic salpingitis in a patient who had had E vermicularis-related appendicitis 5 years earlier.

Adult↗

Postsalpingostomy intercornual bridging with hematosalpinx, chronic salpingitis and perisalpingeal endometriosis. A case report.

Two years after a left salpingo-oophorectomy for a tuboovarian mass from endometriosis and a right salpingostomy for hydrosalpinx, a 28-year-old, infertile woman underwent pelvic surgery for severe pain and progressive endometriosis. The closed, swollen tube arched over the posterior aspect of the uterus, bridging the two cornua; it was filled with blood and showed severe chronic salpingitis and widespread perisalpingeal endometriosis.

Adult↗

[The action of sinusoidal modulated currents with different parameters in experimental chronic infectious salpingitis].

Sinusoidal modulated current (SMC) varying in parameters was applied according to the conventional technique versus an original one developed by the author. The experiment was performed on 66 fertile rabbits with chronic salpingitis. Histological, histochemical and biochemical findings support the advantages of the SMC regimen proposed by the author.

Animals↗

[Can various antibiotics be combined for treating salpingitis?].

Despite the therapeutic progress, the possible consequences of salpingitis remains serious: they consist essentially of sterility and ectopic pregnancy. Unfortunately, the biological and etiological diagnosis encounter many difficulties: samples difficult to obtain, slowness of the laboratory. On the basis of the fact that infections of the Fallopians often involve several organisms, the clinician could begin active treatment from the outset versus enterobacteria, anaerobes and Chlamydia. In vitro investigation of imipenem-ofloxacin and imipenem-doxycycline associations versus Chlamydia trachomatis have demonstrated that imipenem has no anti-chlamydia activity. The addition of ofloxacin or oxydoxycycline has no antagonistic effect. These experimental findings justify the clinician's use of an association of imipenem/cilastine for the initial treatment of upper genital tract infection.

Doxycycline↗

[Acute salpingitis. Celioscopy before and after treatment: 110 cases].

The authors report their experience concerning 110 cases of acute salpingitis that were diagnosed and controlled laparoscopically one month after antibiotic treatment had been achieved. During the second look laparoscopy three parameters were appreciated: pelvic adhesions, tubal patency, and residual inflammation. Laparoscopic findings at the time of early second look have shown relationship between the occurrence of tubal sequelae and the seriousness of initial PID: the relation was statistically significant regarding pelvic adhesions and tubal patency. Chlamydia trachomatis infections were associated with a poorer reproductive potential outcome. Second look laparoscopy seems particularly indicated after severe form of PID (pyosalpinx, tubo-ovarian abscess), in the presence of Chlamydia trachomatis, among young nulliparous woman wishing to conceive.

Acute Disease↗

[Other indications: tubal sterilization, medically assisted procreation, salpingitis, fibromas].

Tubal sterilization is now commonly performed by laparoscopy. Among the available techniques, clips are easy to install and have a low failure rate. Laparoscopy is of considerable value in salpingitis for the diagnosis and treatment of tubo-ovarian abscesses. In medically assisted procreation, laparoscopy is less and less necessary. GIFT and, chiefly, ZIFT are still performed by laparoscopy in case of infertility with normal Fallopian tubes. Laparoscopic myomectomy is a more recent technique, but further experience is needed to assess its value compared with laparotomy.

Female↗