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PubMed1963

Pasteurella pseudotuberculosis infection in man.

Pasteurella pseudotuberculosis has been considered a widespread animal pathogen for many years, but only within the last decade has its capacity to cause human disease been recognized. Two forms of human disease have been established-acute septicemia and mesenteric lymphadenitis. Because mesenteric adenitis is frequently indistinguishable from acute appendicitis, blood serum was obtained from 66 consecutive patients who underwent operation for appendicitis and was examined for agglutinins to seven serotype strains of P. pseudotuberculosis. Agglutinins were obtained in 21.2% of this series. Titres of over 1/100 were found in three of three cases of mesenteric lymphadenitis, one of 11 with no apparent disease, and one of 46 with appendicitis. P. pseudotuberculosis was isolated from a lymph node in the latter case. Two to four follow-up samples of sera in each of these five cases had increasing and then decreasing titres, indicative of active disease. Titres of 1/15 or less were found in five of the cases of appendicitis, in one case of salpingitis, and in three with no apparent disease. The occurrence of these nine cases with low titres may be indicative of previous contact with the organism.Human infection with P. pseudotuberculosis is not unusual in the Edmonton region and is responsible for at least some cases of mesenteric lymphadenitis.

Acute Disease↗

PubMedDate not supplied

[Ascariasis of the cervix].

The authors report a case of ascaris lumbricoïdes located in the cervix uterus of a patient suffering from gonococcal salpingitis. Reviewing the literature, they conclude that the most likely way to the parts genitals was a transanal migration toward vagina.

Adult↗

PubMed1963

THE USE OF HYSTEROSALPINGOGRAPHY IN THE DIAGNOSIS OF INFERTILITY AND OTHER GYNECOLOGICAL CONDITIONS.

Hysterosalpingography was performed on 175 patients who had gynecological symptoms but negative pelvic findings, in order to test a new method of introducing the contrast medium into the uterus and tubes and to record the incidence of pathology revealed. In 132 patients, an attempt was made to secure a No. 14 Foley catheter in the uterus for introducing the contrast medium. This method was successful in 124 patients and can be recommended as being simple, less painful and more efficient than older methods. Of 156 patients with the complaints of infertility (68), dysmenorrhea (31), pelvic pain (29) or menstrual disorder (28), hysterosalpingography revealed significant abnormality in 58; most of these (47) had chronic salpingitis. One flare-up of pelvic inflammation occurred but no other complications were observed. It was concluded that hysterosalpingography is now sufficiently safe and reliable to merit wider utilization in gynecological diagnosis.

Catheterization↗

PubMed1978

The use of laparoscopy in gynaecology.

Diagnostic laparoscopy is of most value in the evaluation of infertility and for completing the gynaecological investigation of obscure cases of chronic pelvic pain. Its use to exclude ectopic pregnancy, salpingitis and pelvic cancer is more controversial. The management of some cases of primary amenorrhoea is aided by laparoscopic gonadal biopsy. The excessive demand for female sterilization will ensure that the laparoscope continues to be used for this purpose and is leading to a compromise. The surgical techniques which have been proved to be most effective are being replaced by methods favoured for their potential reversibility and rapid patient turn-over. If all our laparoscopes were abandoned, gynaecological surgery would perhaps not suffer a major setback, but, for the present, those who neglect laparoscopy are losing an important dimension of modern practice.

Acute Disease↗

PubMed1979

Gonorrhea. Center for Disease Control recommended treatment schedules, 1979.

These recommendations specify appropriate treatment, including dosage of antibiotics for uncomplicated gonococcal infections in adults, infections with penicillinase-producing Neisseria gonorrhoeae, acute salpingitis, acute epididymitis, disseminated gonococcal infections, and gonococcal infections in pediatric patients (including neonatal infections). Special attention is given to important diagnostic considerations, relation of gonococcal infections to concomitant venereal infections, treatment of sexual partners, follow-up, treatment failures, treatments not recommended, allergic problems in treatment, needs for hospitalization, and prevention of gonococcal ophthalmia. Attention is called to the importance of using no less than the recommended dosages of antibiotics.

Amoxicillin↗

PubMedDate not supplied

[Chlamydia trachomatis infection in men and its association with gynecologic alterations in their sexual partners].

OBJECTIVE: To determinate the frequency of Chlamydia trachomatis infection in male partners of infertile couples who attend to the infertility clinic at Instituto Nacional de Perinatología, as well as to compare the clinical data and lifestyle between C. trachomatis-infected and uninfected men to establish a possible association with gynecological damage in their sexual female partners. METHODS: An open prospective study was performed in infertile couples, whose follow up was carried out at Instituto Nacional de Perinatología between June 2000 and April 2001. Urethral and cervical swabs were obtained from each couple and the specimens were subjected to a C. trachomatis-specific liquid-phase hybridization test (PACE-2) and routine microbiological analysis. Semen analysis were also included. A relative risk (RR) test was done to analyze variables and square chi test was used to analyze clinical and gynecological data from female partners and data from semen examination. Statistical differences were considered as significant when the p value was below 0.05. RESULTS: C. trachomatis active infection was found in 14 out of 384 urethral swabs (3.6%). No significant alterations were observed in semen samples of C. trachomatis-infected men, as compared to non-infected individuals. Microbiological analyses of semen showed a significant isolation of Mycoplasma sp (RR = 5.87, IC95% 1.4-24.7). Eight out of fourteen female partners of C. trachomatis-infected men were also infected with C. trachomatis (RR = 10.57, IC95% 5.67-19.7), Candida albicans was other pathogen isolated from 8/14 of those women (RR = 1.89, IC95% 1.17-3.05). Gynecological and obstetrical associations found among female partners of C. trachomatis-infected men were as follows: tubal adhesions in 10/14 (RR = 1.54, IC95% 1.08-2.18), salpingitis in 2/14 (RR = 2.2), history of ectopic pregnancies in 11/14 (RR = 2.94, IC95% 1.01-8.53) and abnormal pregnancy loss in 9/14 (RR = 1.5). CONCLUSION: A low prevalence of C. trachomatis infection was observed among male partners of infertile couples as compared with other reports, but this discrepancy could be attributable to the specimen collection and diagnostic assay used. Otherwise, this data suggests that a chronic pathogen's antigenic stimulation may result in an increased formation of tubal adhesions and/or in ectopic pregnancies among female partners of C. trachomatis-infected individuals. Thus, preventive and control measures must be introduced into men's healthcare services, through laboratory and clinical examination, since these subjects are the main reservoirs of C. trachomatis.

Abortion, Spontaneous↗

PubMed1991

Role of Neisseria gonorrhoeae and Chlamydia trachomatis in intraabdominal abscess formation in the rat.

Our concept of the pathogenesis of acute salpingitis and advanced pelvic infection, such as tuboovarian abscess, is evolving. Although Neisseria gonorrhoeae and Chlamydia trachomatis are thought to play a significant role in acute pelvic inflammatory disease, other microorganisms, such as aerobes and anaerobes, have repeatedly been reported to play a significant role, also, particularly in the patient with advanced disease. A study was designed to evaluate the pathogenesis, and particularly any synergistic role, of some aerobes and anaerobes with N gonorrhoeae and C trachomatis abscess formation. Using the rat model developed by Weinstein and Onderdonk, the study demonstrated that N gonorrhoeae and C trachomatis alone do not produce abscesses. However, when combined with facultative or anaerobic bacteria, synergism with abscess formation is noted frequently. The data support the hypothesis that N gonorrhoeae and C trachomatis initiate infection and that aerobic and anaerobic bacteria act synergistically to produce abscesses. In addition, microorganisms not inoculated were found to be recruited into the infectious process. The organisms may gain access to the peritoneal cavity via the lower genital tract or from transmucosal migration from the intestinal flora.

Abscess↗

PubMed1990

[The significance of the level of C-reactive protein in gynecologic infections].

C-reactive protein, synthesized by the liver, belongs to the group of proteins in the acute stage of inflammation. It has a very short half life of 6 to 8 hours with rapid evolution kinetics. The CRP level has been measured 959 times by the immuno-turbidimetric method in 500 in-patients of the Gynaecology Department of Claude Bernard Hospital. It was measured every 48 hours. The CRP level increases in the immediate post-operative period, reaches its maximum on D3 and falls back to normal between D5 and D7. The CRP level seems to be the most reliable parameter for the diagnosis of pelvic infections (namely salpingitis). It represents the best criterium to assess the effectiveness of the treatments administered to the infected patients (adnexitis, post-operative complications).

Abscess↗

PubMed1989

[Female infertility due to tubal obstruction--management and clinicopathologic study of 66 cases].

Sixty-six cases of female infertility due to obstruction of fallopian tubes from December 1984 to June 1988 were analysed. A discrepancy of 28.8% existed between hysterosalpingography and operative findings, e. g. X-ray revealed blocked tubes, but during operation the tubes were found to be patent. The abnormal and marked tortuosity giving rise to resistance to the passage of oil at the ampullar portion of tubes in the majority of cases may be the explanation. Pathological examination of 48 specimens revealed the chief cause of obstruction was nonspecific infection (50.0%). The next tuberculous infection (31.3%). The third isthmic nodular salpingitis (6.25%) and the fourth endometriosis (4.2%). Operative procedures were done for the purpose of ovum pick-up and to treat the diseased tubes. Three cases of clinical pregnancy as the result of intra-operative ovum pick-up in a program of IVF/ET occurred after 1987 when our IVF technology gradually improved. This result suggests that operation on the tubes did not jeopardize the process of implantation. Among the 14 cases followed up for more than one year 3 cases became pregnant. Operations to relax and straighten up the tortuous part of the tubes or instillation of fluid into the tubes and transplantation of the healthy tube into the single horn uterus were effective. To do an anastomosis on the chronically inflamed and thickened tubes was not helpful.

Adult↗

PubMedDate not supplied

The role of recanalization in tubal pregnancy after sterilization.

Recanalzation at the site of tubal ligation is one of the causes of the failure of such a procedure. The underlying factor could be a pre-existing proliferative disease of the tube, i.e. salpingitis isthmica nodosa. The plexiform type of re-canalization that resulted in the presented case might the cause of the tubal pregnancy. The presence of amenorrhea and /or irregular uterine bleeding in a patient with tubal sterilization requires meticulous investigations to avoid the high morbidity rate associated with missed ectopic gestation. The use of HCG assays and laparoscopic evaluation could improve diagnostic ability in similar cases.

Adult↗

PubMed1989

[Treatment of upper genital infections in women. Multicenter study of the comparative efficacy and tolerance of an amoxicillin-clavulanic acid combination and of a triple antibiotic combination].

Eighty-two patients with laparoscopically confirmed salpingitis were randomly divided into two groups in a multicentre and prospective trial. Single drug therapy with the amoxicillin-clavulanic acid combination was used in 42 patients (group A). The other 40 patients were given a combination of penicillin, aminoside and metronidazole (group B). For each case a secondary prescription for a tetracycline was discussed. Clinical results were comparable in both groups: sooner (at the end of the hospitalization period) in group A: 10 cured, 30 improved and 2 failures against 9 cured, 30 improved in group B. Later (evaluation after 5 to 8 weeks) a relapse was noted in five patients in group A and included one case of angioedema in group B. It is concluded that amoxicillin-clavulanic acid combination is a satisfactory alternative to the penicillin-aminoside-metronidazole combination, especially as it is simpler to use.

Adolescent↗

PubMed1989

[Proposal for a new therapeutic strategy in high genital infections].

78 cases of acute salpingitis were treated with the association Oflocet-Augmentin in a multicenter study. An accurate clinical and bacteriological evaluation was carried out prior to the treatment and a control laparoscopy was performed in 31 cases. A Chlamydia infection was responsible in 56 p. cent of the cases; only one bacteria was identified in 56 cases and an association of two or three bacteria in 15 cases; in 7 cases, no bacteria was identified. The antibiotic association was effective in 96 p. cent of the cases, with a good clinical and biological tolerance. Three failure were reported: one in an infection secondary to a non identified bacteria, and two in Chlamydia infections where, despite the clinical cure, a positive culture persisted in the abdomen. The association Oflocet-Augmentation is therefore recommended in the treatment of high genital infections.

Adolescent↗

PubMed1989

Isolation of Chlamydia Trachomatis from fallopian tubes of healthy women undergoing tubal sterilisation by minlaparotomy in Kenya.

A prospective study of 47 healthy women undergoing tubal sterilisation for contraception was undertaken to find out the rate of isolation of Chlamydia trachomatis from fallopian tubes of these individuals. Chlamydia trachomatis was isolated from the tubes in 7 (14.9%) out of 47 of them. The possible role of this pathogen in the aetiology of salpingitis in our population is discussed.

Adult↗

PubMed1989

[Inflammation of the female genital organs caused by Chlamydia trachomatis].

Chlamydia trachomatis has been presented in a growing number of recent papers as a causative agent of diseases such as cervicitis, endometritis, salpingitis and peritonitis. Based on the results available in literature, significance of an early detection of female genital tract inflammations caused by Chlamydia trachomatis because of its often asymptomatic flow, irreparable sequels of uncured inflammation and possible curing with tetracyclines and macrolides therapy has been discussed.

Chlamydia Infections↗

PubMedDate not supplied

Microscopic evidence of silent inflammation in grossly normal fallopian tubes with ectopic pregnancy.

A normal laparoscopic examination of the pelvis in an infertile patient is usually considered sufficient evidence of normal tubal function. Twelve of 27 tubal ectopic pregnancies which occurred over a 4-year period in patients attending an infertility clinic were in patients with a previously "normal" laparoscopy. In eight patients, salpingectomy was performed, and the whole tube was available for examination by a single pathologist. The eight fallopian tubes, thoroughly examined histologically, all had evidence of ongoing, low-grade salpingitis or postinflammatory endosalpingeal disorganization in areas away from the ectopic pregnancy. These findings suggest that laparoscopy does not exclude significant microscopic tubal disease in at least some women with an apparently normal pelvis, and that this may be a cause of ectopic pregnancy and perhaps "idiopathic" infertility.

Fallopian Tubes↗

PubMed1988

[Primary diagnosis in acute adnexitis].

Though acute salpingitis is the most frequent gynecological illness of a young woman, it occurs nevertheless less frequently than it is diagnosed. The reason for this is to be found above all in the fact, that the criteria of the findings are judged too superficially. If simple anamnestic, clinical or biochemical parameters such as the characteristics and duration of the pain, the findings of gynecological examination, BSR and considerations about differential diagnosis were rated more precisely, considerably fewer cases would have to be assigned to laparoscopy and the elucidation of the indistinct abdominal pains could be started more efficiently.

Adult↗

PubMed1985

[Our experience in the serodetection of Chlamydia infections in tubal pathology].

Chlamydia appears to be an increasingly frequent cause of salpingitis and its complications (sterility, extra-uterine pregnancy). The difficulty of isolating Chlamydia in cell cultures has led us to study the value of serology in the form of immunofluorescence and ELISA. This study is based on 475 cases (206 controls and 269 women with tubal disease). Although it is difficult to interpret an isolated IgG level, the results nevertheless confirmed the value of serodetection: especially the comparison between the control group (18.44% positive) and the pathological group (62.08% positive) and the effectiveness obtained when cases of tubal sterility were treated with appropriate antibiotics, alone or in combination with surgery.

Animals↗

PubMed1988

Oophorovesicular-colonic fistula: a rare complication of Crohn's disease.

Salpingitis and vesicular fistulas are rare complications of Crohn's disease. In this report the authors describe a case of oophorovesicular-colonic fistula secondary to Crohn's disease. The patient presented with bleeding from the bladder during menstruation, fecaluria and pneumaturia. A single-stage left salpingo-oophorectomy, sigmoid resection and repair of the fistula were carried out, with complete resolution of symptoms and preservation of fertility potential.

Adult↗