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PubMed1981

Antibodies to Chlamydia trachomatis, Mycoplasma hominis, and Neisseria gonorrhoeae in sera from patients with acute salpingitis.

Paired sera from 60 consecutive patients with acute salpingitis, confirmed by laparoscopy, were examined for serum antibodies to Chlamydia trachomatis, Mycoplasma hominis, and Neisseria gonorrhoeae. By a microimmunofluorescence (MIF) test IgM or IgG antibodies to C trachomatis or both were present in sera from 80% of the patients' by indirect haemagglutination (IHA) tests antibodies to M hominis and N gonorrhoeae pilar antigens were present in 40% and 18% respectively. In a control group of 50 pregnant women antibodies to the same three organisms occurred in 8%, 8%, and 6%. Evidence of current chlamydial infection was found in 35 (58%) and of current gonococcal infection in five (8%) of the 60 patients by culture or serological tests or both. The results of chlamydial antibody tests correlated with the severity of the tubal inflammation (as shown by laparoscopy) and the duration of the lower abdominal pain before attendance. The predictive values of a positive and a negative MIF test result were 44% and 83% respectively and of the IHA gonococcal antibody test 36% and 100% respectively. Significant rises in titre of antibodies to M hominis were found in 12% of patients. A four-fold or greater rise in titre indicated probable double infections with chlamydia and mycoplasmas in 7% of patients. Thus, at present gonococcal salpingitis appears to form only a small proportion of all cases of salpingitis in southern Sweden, and in patients with nongonococcal salpingitis infections with C trachomatis and M hominis commonly occur.

Acute Disease↗
PubMed1990

Peritoneal fluid leukotriene B4 and prostaglandin E2 in acute salpingitis.

Concentrations of leukotriene B4 (LTB4) and prostaglandin E2 (PGE2) in peritoneal fluid were measured in 19 women with suspected acute pelvic inflammatory disease. Acute salpingitis was verified by laparoscopy in 16 cases; 11 of them had isolation of microbes from the peritoneal cavity. Means (+/- SD) levels of peritoneal fluid LTB4 and PGE2 in acute salpingitis were 506 +/- 288 and 378 +/- 330 pg/ml, respectively, and higher (p less than 0.001) than the levels in the peritoneal fluid of 20 healthy controls: LTB4 44 +/- 57, PGE2 11 +/- 2 pg/ml, respectively. An inflammatory cytologic pattern was found in the peritoneal fluid in all the cases with acute salpingitis, neutrophils being the prominent cells. These chemical mediators of inflammation in peritoneal fluid may have a role in the development of scarring and peritubal adhesions found after acute salpingitis.

Acute Disease↗
PubMed1992

In vivo tumor necrosis factor production in women with salpingitis.

Immune mediated mechanisms might contribute to damage of the fallopian tube in instances of salpingitis. Using a filter paper technique to obtain samples during the surgical procedure, we examined fluids from the reproductive tract organs of seven women with salpingitis and five controls, for evidence of tumor necrosis factor (TNF). TNF, produced principally by macrophages, is a substantial mediator of inflammatory responses. In three women culture-positive for Chlamydia trachomatis, TNF was identified only in those fallopian tubes with visual evidence of disease. Fluids obtained from morphologically normal tubes, as well as from the ovaries and uterus, were negative. In three women with negative fallopian tube cultures but visual evidence of salpingitis, TNF was also identified in fluids from damaged, but not from normal, tubes. Ovarian and uterine fluids of the women were also TNF positive. The last patient, also culture-negative, had TNF only in one affected tube. All five patients in the control group had negative findings at all genital tract sites. Only one patient had TNF in her serum. Thus, localized cell-mediated immune system activation, identified by TNF production, appears to be a typical component of salpingitis.

Bacteria↗
PubMed1990

Severity of salpingitis in mice after primary and repeated inoculation with a human strain of Chlamydia trachomatis.

Groups of inbred female mice of strains CBA or C3H were infected genitally with a pathogenic human strain of Chlamydia trachomatis (N.I.1, serovar F) known to produce salpingitis and infertility in mice. Mice were inoculated under the ovarian bursa or directly into the uterine cavity with chlamydiae (test groups) or with sucrose-phosphate transport medium (control groups) before being challenged with chlamydiae by the same route 12-17 weeks later. Twenty-five pairs of test and control animals were killed from 7 to 77 days after challenge and oviductal inflammatory changes, recovery of organisms, and antibody responses were compared in the two groups. Salpingitis in the mice infected previously (tests groups) was more severe than in the controls in 56% of comparisons, the same in 24% and less severe in 20%. However, despite the increase in the severity of disease, shedding of C. trachomatis from the lower genital tract was less prolonged after rechallenge or did not occur. Salpingitis occurred in spite of the almost certain presence of pre-existing serum antibody, and accelerated and accentuated antibody response in the rechallenged mice. Furthermore, the continued existence of high titres of antibody was not associated with less severe disease. Thus, the results reveal that previous exposure to chlamydiae does not prevent salpingitis and suggest that its severity is influenced by cell-mediated immune mechanisms.

Animals↗
PubMed1989

[Role of Chlamydia trachomatis in tubal pathology (acute salpingitis and tubal sterility). Microbiological study of 175 samples of peritoneal fluid].

The study was carried out on 175 patients who underwent laparoscopy together with search for chlamydia in the peritoneal fluid when they were having investigations for sterility or for pelvic pain. These patients are classified into three groups according to the clinical and laparoscopic features: 50 cases of acute salpingitis. 104 cases of tubal sterility and 21 control cases who were normal on laparoscopy. The mean age was 25.7 years for acute salpingitis and 30.4 years for tubal sterility. The purpose of this study was to work out the role played by chlamydia trachomatis in tubal phatology and two techniques were used at the same time: The identification of chlamydia trachomatis in 175 samples of peritoneal fluid taken during a laparoscopy; Research for anti-chlamydia antibodies in serum using an indirect micro-immunofluorescent technique. Cell cultures were performed after the peritoneal fluid had been centrifuged. It had been in transport medium 2 SP and frozen. Our technical methods for isolating chlamydia (microplaque culture on Hela lines, incubation in the presence of cycloheximide and research for chlamydial inclusion bodies using direct immunofluorescence with monoclonal antibodies and 2 successive passages of the cells) have allowed us to confirm that chlamydia was present in 44% of cases of acute salpingitis and in 37% of cases of tubal sterility. The search for anti-chlamydial antibodies in the serum in indirect immunofluorescence with a single antigen (of L2 serotype) gave positive results which were comparable to those in other studies, i.e. 50% of positive serological results in acute salpingitis and 63% in tubal sterility.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1985

Laparoscopic findings and contraceptive use in women with signs and symptoms suggestive of acute salpingitis.

Laparoscopic findings in women with clinical signs and symptoms of pelvic inflammatory disease were correlated with contraceptive use in a case-control study. Of the 738 women, 544 (73.7%) had laparoscopic signs of acute salpingitis, whereas 194 (26.3%) had visually normal fallopian tubes (nonsalpingitis). Acute salpingitis was seen in 59.8% of the 286 patients using oral contraceptives, in 80.6% of the 227 patients using an intrauterine device (IUD), and in 84.4% of the 225 patients using barrier methods or not using contraceptives (reference group). To estimate the relative risk of acute salpingitis, logistic regression analysis adjusting for age and duration of pain before laparoscopy was used. For oral contraceptive users versus the reference group the adjusted relative risk was estimated at 0.24 (95% confidence interval 0.15 to 0.38, P less than .0001), and for IUD users versus the reference group a relative risk was estimated at 0.83 (95% confidence interval 0.49 to 1.38, P = .46). The relative risk of salpingitis among oral contraceptive users versus the reference group was 0.22 (P = .005), and 0.06 (P = .001) for women infected with Chlamydia trachomatis and/or Neisseria gonorrhoeae, respectively. In patients with pelvic inflammatory disease, spread of the inflammation to the fallopian tubes seems to be inhibited in oral contraceptive users.

Adolescent↗
PubMed1985

[Acute gonococcal salpingitis].

The authors describe their experience in handling cases of acute salpingitis in a retrospective study that lasted six years. The protocol of investigation in particular consisted in routine laparoscopy and a complete bacteriological investigation. 266 patients had laparoscopy on suspicion of salpingitis and the diagnosis was confirmed in 199 cases (64.8%). Out of the 134 patients who were fully explored bacteriologically and kept in the study the principal group consisted of cases of gonococcal salpingitis (41.8%), whereas 29.8% of the cases had infection with opportunistic pathogens and 28.3% were of doubtful aetiology or where no bacteria were discovered. The figures for recovery of gonococcal bacteria were constant throughout the six years of the study. Gonococcal salpingitis occurred more often in younger women (the mean age was 24.4 years). The signs that were statistically most frequent were: discharge, metrorrhagia and a raised sedimentation rate. The differences that concerned the epidemiology of the cases as well as the clinical and bacteriological data as given in our series and in the literature are presented and discussed.

Adolescent↗
PubMed1986

Bilateral salpingitis, hydrosalpinx and oophoritis in a mare.

Bilateral salpingitis, hydrosalpinx and oophoritis were diagnosed in a mare with concurrent lymphosarcoma. Salpingitis, hydrosalpinx and oophoritis are rare in the mare (1,2,3,5,8,9,11-13). Bilateral salpingitis is an important cause of infertility in all species and is most often due to ascending infection (3-5,10,11). The source of salpingitis in this mare probably was ascending infection from the uterus after parturition. The apparent infertility of the mare was attributed to debilitation from the lymphosarcoma and multiplicity of genital pathoses.

Animals↗
PubMed1983

Laparoscopy in women with chlamydial infection and pelvic pain: a comparison of patients with and without salpingitis.

A review was made of clinical and laboratory findings in 104 women who, during 1978 to 1981, were subjected to laparoscopy because of symptoms suggestive of acute salpingitis, and who harbored Chlamydia trachomatis but not Neisseria gonorrhoeae in the genital tract. The patients with acute salpingitis (N = 76) did not differ significantly from those with visually normal fallopian tubes (N = 28) in regard to age distribution, parity, contraceptive method used, proportion of women with urethritis symptoms, increased vaginal discharge, vomiting, diarrhea, elevated rectal temperature, elevated white blood cell count, and palpable pelvic masses. The acute salpingitis patients more often had irregular bleeding and an elevated erythrocyte sedimentation rate, whereas the patients without acute salpingitis more often had a short history of pelvic pain. The two groups overlapped considerably with respect to the number of symptoms and clinical signs of pelvic infection. The results emphasize the value of laparoscopy in the diagnosis or exclusion of a tubal infection in association with a chlamydial genital infection and pelvic pain, even if there are comparatively few additional symptoms of ascending infection.

Chlamydia Infections↗
PubMed1984

[Consequences of sexually transmitted diseases in women: salpingitis].

Sexually transmitted disease plays a predominant role in both acute salpingitis and in chronic silent salpingitis. Chlamydia trachomatis appears to be the agent most frequently involved in both cases, but we must not underestimate the role of gonococcus, Mycoplasma and opportunistic bacteria. The tendency of Chlamydia trachomatis to cause sub-clinical, sub-acute and even chronic infections raises a number of questions concerning the real criteria of cure of an acute salpingitis and the possibilities of early detection of such infections when they are chronic from the start, as these infections are as equally important as acute salpingitis in the pathogenesis of tubal sterility.

Acute Disease↗
PubMed1983

Salpingitis isthmica nodosa: a high-risk factor for tubal pregnancy.

A prospective and retrospective study was undertaken to analyze pathologic lesions in fallopian tubes of 200 consecutive tubal pregnancies. In a retrospective analysis of 100 cases of tubal pregnancy, seven cases were reported to contain salpingitis isthmica nodosa. After review, 27 cases were found to have this lesion. The prospective study employed 100 consecutive tubal pregnancy specimens thoroughly sectioned for microscopic examination. Salpingitis isthmica nodosa was observed in 57 of these 100 cases. In a control series of 100 fallopian tubes obtained from autopsy and surgical specimens, five tubes showed salpingitis isthmica nodosa. These observations indicate a significant association between tubal pregnancy and salpingitis isthmica nodosa.

Adolescent↗
PubMed1980

Experimental bovine genital ureaplasmosis. II. Granular vulvitis, endometritis and salpingitis following uterine inoculation.

Twenty-three virgin Holstein heifers received uterine inoculations with ureaplasma and were necropsied one to thirteen days later. Three heifers inoculated intracervically were necropsied on days 3, 5 and 11.Granular vulvitis was produced on average by 3.6 days in fourteen of sixteen uterine inoculated heifers monitored for four or more days. Two cervically inoculated heifers monitored for over four days also developed granular vulvitis by the fourth day. At necropsy, ureaplasma was recovered from 94% of uterine horn cultures for the first four days postinoculation and 50% during days 5 to 7. Thereafter all uterine cultures were negative. The percentage of positive ureaplasma recoveries from uterine tube flushings was lower than for uterine horns but remained positive for a longer period. By day 7, three of four uterine tube flushings were still positive. No bacterial pathogens were isolated from the uterine horns or uterine tube flushings. On histopathology 50% of uterine inoculated heifers had endometritis up to six days postinoculation and a slightly higher percentage (58%) had salpingitis. Endometritis was not found in any heifers after day 6. Residual salpingitis was present in one heifer on day 7. Endometritis was present in cervically inoculated heifers necropsied on days 3 and 5 but not on day 11. Salpingitis was not found in any of the three cervically inoculated animals. The study concluded that some strains of ureaplasma are pathogenic for the upper reproductive tract of the cow and should be considered significant when isolated from cases of granular vulvitis, endometritis or salpingitis.

Animals↗
PubMed1979

Bacteroides fragilis in acute salpingitis.

The bacteriology of acute salpingitis was studied in 87 patients. Gonococci were recovered from 18 patients. Lower yields of bacteria were isolated in the peritoneal fluid than from the vaginal cultures, and a poor correlation was observed between the peritoneal fluid and vaginal cultures. Anaerobic bacteria dominated in both sites. Staphylococci, streptococci, enterobacteria, peptostreptococci, peptococci, lactobacilli and bacteroides normally present in the vagina were the predominant isolates recovered from the culdocentesis. Paired acute and convalescent-phase sera obtained from patients with isolates of Bacteroides fragilis were assayed for antibody response to the polysaccharide antigen of B. fragilis. Significant titer increases were observed in sera from only two out of eight patients with non-gonococcal salpingitis and no titer changes were noticed in two patients with gonococcal. These findings suggest that B. fragilis only infrequently plays an etiologic role in acute salpingitis.

Acute Disease↗
PubMed1977

Clinical response of patients with gonococcal endocervicitis and endometritis-salpingitis-peritonitis to doxycycline.

The clinical response to single-drug therapy with doxycycline was evaluated in 25 patients with gonococcal endoceruicitis and was correlated with the bacterial isolates present within the cul-de-sac. The 10 patients with gonococcal salpingitis salpingitis and the three patients with gonococcal peritonitis exhibited excellent clinical responses. When polymicrobial infection coexisted with gonococcal peritonitis or functioned without the concomitant presence of Neisseria gonorrhoeae, a significantly altered therapeutic response was observed in four of the 12 patients. Four patients in this grouping exhibited either secondary temperature elevations or lack of a significant alteration of the white blood cell count, two features which were not characteristic of the patients with either gonococcal salpingitis or peritonitis. In the cases of polymicrobial peritonitis, there was a poor correlation between ensuing clinical response and in vitro resistance of one or more cul-de-sac isolated to doxycycline. The presence of a resistant organism did not preclude a good or satisfactory clinical response. The absence of a resistant organism correlated well with a good clinical response.

Adolescent↗
PubMed1980

Gonococcal salpingitis is less likely to recur with Neisseria gonorrhoeae of the same principal outer membrane protein antigenic type.

If protective immunity were to develop following an episode of gonococcal pelvic inflammatory disease (salpingitis), PID should recur with organisms bearing antigens that do not react with these immune mechanisms. To test this hypothesis, gonococci from 15 women with gonococcal PID, who experienced 19 subsequent episodes of gonococcal infection, were serotyped for their principal outer membrane protein (Protein I) antigens. Of nine cases in which the initial and subsequent infections involved the same Protein I serotype, none was associated with recurrence of PID. Of 10 cases in which the initial and subsequent infections involved different Protein I types, five were associated with recurrent PID (p = 0.02). These data suggest that an episode of gonococcal PID produces some immunity to repeated episodes of salpingitis with the same Protein I serotype, while not preventing reinfection with the same Protein I serotype. The immune response to Protein I antigen may thus provide serotype-specific protection against gonococcal salpingitis.

Antigens, Bacterial↗
PubMed1980

Microbiology and pathogenesis of acute salpingitis as determined by laparoscopy: what is the appropriate site to sample?

Acute salpingitis is a polymicrobial disease. Neisseria gonorrhoeae and anaerobic gram-positive cocci were the predominant microorganisms isolated from the fallopian tubes of salpingitis patients. Gonococci were isolated from the fallopian tubes in eight of 35 (23%) patients; anaerobic bacteria were recovered from 10 of 35 (28.5%). Although Chlamydia trachomatis was not recovered from the fallopian tube exudate, there was abundant serologic evidence of chlamydial infection in the salpingitis patients. Twenty-three percent of patients with paired sera had a fourfold rise in IgM and IgG titer, which was consistent with systemic chlamydial infection. Comparison of cultures obtained via laparoscopy and culdocentesis suggested that culdocentesis is not an accurate reflection of the microbial milieu in the fallopian tube.

Ascitic Fluid↗
PubMed1980

Sacroiliitis in women--a late sequela to acute salpingitis.

Fifty-seven women who were treated for severe acute salpingitis between June, 1974, and June, 1976, were examined in 1978, 24 to 48 months after their first hospitalization. At the same time, 31 healthy women matched for age and parity were examined. All patients and control subjects were examined independently by a gynecologist and a rheumatologist. Forty-two of the patients and all control subjects were examined by quantitative 99mTc-pertechnetate scanning of the sacroiliac joints. These same joints also were examined by x-ray in the 57 patients. Sacroiliitis was documented in 39 of the 57 salpingitis patients (68%) and in one of the control subjects (3%), a difference which was statistically significant. There was no difference between the two groups in the presence of histocompatibility antigen HLA B27. The findings strongly suggest a correlation between severe acute salpingitis and sacroiliitis in women.

Adult↗
PubMed1989

High hepatitis B carrier rate among non-Oriental patients with acute salpingitis.

Hepatitis B surface antigen screening was performed on non-Oriental patients with the diagnosis of acute salpingitis. Six of 59 (10.17%) had hepatitis B surface antigenemia. We therefore recommend hepatitis B screening for all patients with salpingitis. The detection of covert hepatitis B helps to protect hospital staff and provides important information for the patient. Further, the administration of hepatitis B vaccine may be appropriate for those patients with acute salpingitis who are found to be hepatitis B surface antigen-negative.

Acute Disease↗