Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SALPINGITIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1998

Presence of the major outer-membrane protein of Chlamydia trachomatis in patients with chronic salpingitis and salpingitis isthmica nodosa with tubal occlusion.

OBJECTIVE: To determine the presence of the major outer-membrane protein of Chlamydia trachomatis in fallopian tube tissue specimens of infertile women with chronic salpingitis and/or salpingitis isthmica nodosa with tubal occlusion. DESIGN: Prospective controlled study. SETTING: Department of Obstetrics and Gynecology, University of Bochum, Herne, Germany. PATIENT(S): Fifty-six consecutive infertile women with histologically documented chronic salpingitis and/or salpingitis isthmica nodosa and bilateral tubal occlusions were evaluated. They were compared with 28 fertile women. INTERVENTION(S): Fallopian tube tissue specimens were taken during reconstructive infertility surgery, including cesarean section and tubal ligation. MAIN OUTCOME MEASURE(S): Detection of the major outer-membrane protein of C. trachomatis in fallopian tube tissue specimens by a direct fluorescent antibody test. RESULT(S): The major outer-membrane protein of C. trachomatis was found in fallopian tube tissue specimens in 11 of 56 infertile patients (20%) with chronic salpingitis and/or salpingitis isthmica nodosa. The median titer of IgG serum antibodies to Chlamydia was significantly higher in women with the major outer-membrane protein of C. trachomatis than in patients without this antigen. In comparison, the major outer-membrane protein of C. trachomatis was not found in any of the fallopian tube tissue specimens of the control group. CONCLUSION(S): The presence of the major outer-membrane protein of C. trachomatis is associated with chronic salpingitis and/or salpingitis isthmica nodosa with tubal occlusion.

Adult↗
PubMed1985

Importance of Mycoplasma hominis in acute salpingitis assessed by culture and serological tests.

In 95 women with a provisional diagnosis of pelvic inflammatory disease, a final diagnosis of acute salpingitis was confirmed by laparoscopy in 46 and 10 had strong clinical evidence of acute salpingitis. The findings in the remaining 39 patients without signs of acute salpingitis by laparoscopy were used as a standard of reference. Criteria for the diagnosis of possible mycoplasmal salpingitis were tentatively defined as the isolation of Mycoplasma hominis from the cervix together with positive test results for M hominis antibodies (a titre of greater than or equal to 1/1280 or a change in titre, or both); these criteria were fulfilled in 12 patients with acute salpingitis. A positive correlation between mycoplasmal salpingitis and chlamydial salpingitis or gonococcal salpingitis, or both, was significant. Mycoplasmal salpingitis was not associated with any characteristic clinical feature different from those of patients with non-mycoplasmal salpingitis. Our findings do not support the view that M hominis is an important primary pathogen in acute salpingitis.

Acute Disease↗
PubMed1994

Antibodies to opacity proteins (Opa) correlate with a reduced risk of gonococcal salpingitis.

Acute salpingitis complicating cervical gonococcal infection is a significant cause of infertility. Relatively little data are available concerning the pathophysiologic mechanisms of this disease. A cohort of 243 prostitutes residing in Nairobi were followed between March 1985 and April 1988. Gonococcal cultures were performed at each visit, and acute salpingitis was diagnosed clinically. Serum at enrollment was tested by immunoblot for antibody to gonococcal outer membrane proteins. 8.6% (146/1689) of gonococcal infections were complicated by salpingitis. Increased risk of salpingitis was associated with younger age, shorter duration of prostitution, HIV infection, number of gonococcal infections, and episodes of nongonococcal salpingitis. Rmp antibody increased the risk of salpingitis. Antibody to Opa decreased the risk of salpingitis. By logistic regression analysis, antibody to Opa was independently associated with decreased risk of gonococcal salpingitis (adjusted odds ratio [OR], 0.35; 95% confidence interval [95%CI], 0.17-0.76); HIV infection (adjusted OR, 3.5; 95% CI, 0.96-12.8) and episodes of nongonococcal salpingitis (adjusted OR, 3.4; 95% CI, 1.8-6.4) were independently associated with an increased risk of salpingitis. Antibody to Opa appears to protect against ascending gonococcal infection, perhaps by interfering with Opa mediated adherence and endocytosis. The demonstration of natural immunity that protects against upper genital tract infection in women suggests that a vaccine to prevent gonococcal salpingitis is possible.

Adult↗
PubMed1985

Serum IgG and IgA antibodies specific for Chlamydia trachomatis in salpingitis patients as determined by the immunoperoxidase assay.

The feasibility of applying elevated Chlamydia trachomatis specific IgG antibody and serum IgA antibodies as a non-invasive screening test for C. trachomatis associated salpingitis was analysed in 54 salpingitis patients and 294 apparently healthy women by the single antigen (L2) immunoperoxidase assay (IPA). The prevalence rate of C. trachomatis IgG antibody (titre greater than or equal to 64) was significantly higher in the salpingitis patients in comparison to control (67% versus 23%). The prevalence rate of elevated C. trachomatis IgG titres (greater than or equal to 128, greater than or equal to 256 and greater than or equal to 512) was significantly higher in the salpingitis patients as compared to the controls. For example, at an IgG titre of greater than or equal to 128 the prevalence rate was 57% in the salpingitis patients and 8% in the healthy controls (p less than 0.0001). The prevalence of C. trachomatis IgA antibodies (titre greater than or equal to 16) was significantly higher in salpingitis patients in comparison to controls (37% versus 4%). The prevalence of elevated IgA titres (greater than or equal to 32 and greater than or equal to 64) was found to be significantly higher in salpingitis patients as compared to controls. All the IgG seropositive salpingitis patients were also found to have C. trachomatis IgG antibodies. It appears that testing for IgG antibodies at a serum dilution of 1:128, and for IgA antibodies at a dilution of 1:16 by the IPA test comprises the best combination for the differentiation between the salpingitis patients and apparently healthy controls, and it is suggested that this be used as a marker of active C. trachomatis infection.

Adolescent↗
PubMed1985

High failure rates in outpatient treatment of salpingitis with either tetracycline alone or penicillin/ampicillin combination.

Eight hundred twenty-five ambulatory women with a clinical diagnosis of salpingitis were randomized to a 10-day course of either penicillin/ampicillin or tetracycline. Forty-four percent of women had gonococcal salpingitis and 56% nongonococcal salpingitis. Overall, both regimens cured equal proportions of women: At 30 days, 81% were cured by penicillin/ampicillin and 82% by tetracycline. However, the proportion of women with gonococcal salpingitis cured by 30 days was significantly greater than that of women with nongonococcal salpingitis. By 30 days, 14% of women with gonococcal salpingitis and 21% of women with nongonococcal salpingitis were not cured by either regimen. These data suggest that both regimens were only marginally acceptable for women with gonococcal salpingitis and that neither regimen was acceptable for nongonococcal salpingitis.

Adolescent↗
PubMed1990

Endometrial histopathology in patients with culture-proved upper genital tract infection and laparoscopically diagnosed acute salpingitis.

To define and quantitate histologic changes in the endometrium that best correlate with documented upper genital tract infection (UGTI) and laparoscopically diagnosed acute salpingitis, we studied endometrial biopsy specimens from 69 consecutive patients with clinically suspected acute pelvic inflammatory disease (PID) who underwent microbiological evaluation for UGTI and laparoscopic examination for acute salpingitis. Both UGTI and acute laparoscopically confirmed salpingitis were present in 37 patients (54%), UGTI without salpingitis in 1 (1%), salpingitis without UGTI in 11 (16%), and neither UGTI nor salpingitis in 20 (29%). Chlamydia trachomatis or Neisseria gonorrhoeae UGTI was found in 34 women, Escherichia coli in two patients, Peptococcus magnus in one woman, and with Streptococcus agalactiae in one woman. The following features were correlated both with UGTI and with salpingitis: presence of any neutrophils in the endometrial surface epithelium; neutrophils within gland lumens; dense subepithelial stromal lymphocytic infiltration; any stromal plasma cells; and germinal centers containing transformed lymphocytes. The simultaneous presence of five or more neutrophils per X 400 field in endometrial surface epithelium, together with one or more plasma cell per X 120 field in endometrial stroma, was the best predictor of UGTI plus salpingitis. This combination had a sensitivity of 92% and a specificity of 87% for predicting the diagnosis of both UGTI and laparoscopically confirmable acute salpingitis. Prospective studies are needed to assess the usefulness of these criteria.

Acute Disease↗
PubMed1995

Clinical, laparoscopic and microbiological findings in acute salpingitis: report on a United Kingdom cohort.

OBJECTIVE: To determine the clinical features and microbial aetiology of acute salpingitis in women attending an inner city teaching hospital. DESIGN: Prospective, longitudinal cohort study. SUBJECTS: One hundred and forty-seven women presenting consecutively with acute abdominal pain and clinical signs of acute salpingitis were evaluated microbiologically and laparoscopically. RESULTS: One hundred and four women (70.7%) had acute salpingitis diagnosed at laparoscopy. Other pathological conditions were identified in 20 women (13.6%). No visually identifiable pathology was found in 23 (15.6%). Thirty-five women with acute salpingitis had evidence of pelvic adhesions (33.7%). Bilateral tubal occlusion was present in 6 (5.8%) cases. Chlamydia trachomatis was identified in the genital tract in 40 (38.5%) of the women with acute salpingitis and Neisseria gonorrhoeae in 15 (14.4%). A dual infection was present in eight cases (7.7%). Serological evidence suggested that a further seven women (6.7%) had acute chlamydial infections at the time of diagnosis. C. trachomatis was identified in the genital tract of 5/23 (21.7%) of the women who had no laparoscopic evidence of intra-abdominal pathology. CONCLUSIONS: The responsible care of women with suspected acute salpingitis depends on establishing an accurate diagnosis, so that appropriate therapy can be instigated. This study provides evidence to challenge the outpatient management of acute salpingitis on clinical grounds alone as potentially inadequate. Early laparoscopy in hospitalised women improves diagnostic precision and accurately determines disease severity, providing prognostic information for future fertility. In this urban population, sexually transmitted micro-organisms were the commonest pathogens found in the genital tract of women with acute salpingitis. The high prevalence of C. trachomatis in these women suggests that appropriate chemotherapy for acute salpingitis should always include a specific antichlamydial agent.

Acute Disease↗
PubMed1977

Diagnosis and treatment of acute salpingitis.

Acute salpingitis is one of the most common acute gynecologic diseases and occurs in approximately 750,000 women each year in the United States. Use of laparoscopy to confirm the diagnosis of acute salpingitis has shown that the signs and symptoms classically ascribed to this disease are not specific to it. Fever, leukocytosis, elevated ESR and adnexal masses or swelling are not necessary to make a diagnosis of acute salpingitis. Lower abdominal pain and adnexal tenderness are the most consistent findings. Microbiologic data obtained by laparoscopy and culdocentesis have raised questions about the role of N. gonorrhoeae in salpingitis and have demonstrated that, as in pelvic infections generally, acute salpingitis is associated with mixed aerobic-anaerobic bacterial flora. Good results in the treatment of acute salpingitis depend upon: (1) early diagnosis, (2) hospitalization and bed rest, (3) the use of antibiotic therapy that takes into account the polymicrobial etiology of acute salpingitis, (4) prevention of recurrent episodes of salpingitis through efforts at patient education and identification and treatment of sexual partners. Most important, we must remember that what is at stake is often the future reproductive potential of a young woman. It must be weighed against both patient and physician convenience and cost. Further investigative efforts are essential to determine the role of IUDs in pelvic infections, discover the true microbiologic etiology of salpingitis and establish appropriate antimicrobial treatment as determined by prospective, microbiologically controlled investigations.

Acute Disease↗
PubMed1991

Recurrence of ectopic pregnancy: the role of salpingitis.

We evaluated the role of salpingitis on the recurrence of ectopic pregnancy from a historical cohort of 2501 women who had undergone laparoscopic examination for acute salpingitis. We used pregnancy (N = 2899) as the unit of analysis and a modified conditional logistic regression to estimate a pairwise odds ratio as a measure of the recurrence of ectopic pregnancy. Among the second or higher order of pregnancy, the recurrence was 21.7%. For pregnancies with a prior uterine pregnancy, the ectopic pregnancy rate increased with prior salpingitis scores constructed from a combination of prior salpingitis episodes and severity (0 score, 2.7%; 1 to 2 scores, 4.8%; and greater than or equal to 3 scores, 12.1%). For those with a prior ectopic pregnancy, the rate did not increase with prior salpingitis scores (score 0, 20.0%; score 1 or 2, 19.2%; and score greater than or equal to 3, 26.9%). The adjusted pairwise odds ratio was 2.2 and was practically unchanged (2.1) after additional adjustment with prior salpingitis scores. These findings confirm salpingitis as a risk factor for first ectopic pregnancy, but once a woman had an ectopic pregnancy, previous salpingitis might not add any incremental risk.

Adult↗
PubMed1991

Increased inducibility of inflammatory mediators from peripheral blood mononuclear cells of women with salpingitis.

To investigate whether immune system activation may contribute to the tissue damage observed in salpingitis, we isolated peripheral blood mononuclear cells and quantitated production of the monocyte activation products tumor necrosis factor-alpha, interleukin-1, and interleukin-6. Unstimulated cells from 7 of 20 women with salpingitis spontaneously released tumor necrosis factor at a concentration greater than 2 SD above the mean value produced by cells from 29 healthy donors. Interferon gamma (200 U/ml) further induced production of tumor necrosis factor from mononuclear cells of 11 women with salpingitis. In contrast, production of tumor necrosis factor by each of 23 other patients who lacked laparoscopic or clinical evidence of salpingitis was similar to that of the controls. In a subset of women whose cells were tested for production of other monokines, three of nine women with salpingitis spontaneously released interleukin-1 but none of the others did so. Four of nine patients with salpingitis also produced interleukin-6, but none of the others did so. None of the monokines were detected in serum from any subject. The results suggest that monocytes from women with salpingitis are primed in vivo and produce inflammatory mediators under conditions where monocytes from other women are poorly responsive. This increased monokine inducibility may contribute to the tubal damage that is the hallmark of salpingitis.

Cells, Cultured↗
PubMed1994

Observations concerning the microbial etiology of acute salpingitis.

OBJECTIVES: The specific aims of this study were (1) to describe the microbiologic characteristics of patients with acute salpingitis and (2) to determine the incidence of bacterial vaginosis in patients with acute salpingitis and whether bacterial vaginosis microorganisms were common upper-genital-tract isolates in these patients. STUDY DESIGN: Women with pelvic inflammatory disease underwent laparoscopy to confirm the diagnosis of acute salpingitis and for culture of the fallopian tubes and cul-de-sac. Endometrial and minute fimbrial biopsies were performed, and specimens were evaluated for evidence of inflammation. Bacterial vaginosis was diagnosed by vaginal Gram stain. RESULTS: Eighty-four patients had visually confirmed acute salpingitis. Neisseria gonorrhoeae or Chlamydia trachomatis was isolated from 65 (77.4%) patients. Vaginal microorganisms were isolated from the endometrium in 16 (31.4%) of 51 cases and from the cul-de-sac in 12 (14.3%) of 84 cases. Bacterial vaginosis was present in 61.8% of patients with acute salpingitis, and 100% of anaerobes isolated from the upper genital tract of patients with acute salpingitis were bacterial vaginosis microorganisms. These anaerobes were isolated from the upper genital tract in the absence of a concurrent gonococcal, chlamydial, or Haemophilus influenzae infection in only two cases. CONCLUSIONS: The initiation of acute salpingitis is predominantly due to the ascending spread of sexually transmitted microorganisms. Bacterial vaginosis is a common concurrent disorder of women with acute salpingitis, and bacterial vaginosis microorganisms are commonly isolated from the upper genital tracts of patients with pelvic inflammatory disease.

Acute Disease↗
PubMed2000

The frequency of salpingitis and ectopic pregnancy as epidemiologic markers of Chlamydia trachomatis.

BACKGROUND: To study the incidence of non-gonococcal salpingitis, gonococcal salpingitis and ectopic pregnancy in a defined population over a 28-year period on the assumption that the frequency of salpingitis and ectopic pregnancy may indirectly illustrate the epidemiological pattern of Chlamydia trachomatis. DESIGN: A retrospective epidemiological study. SETTING: University hospital with an urban catchment area. PATIENTS: Five thousand two hundred and thirty-three patients admitted to the hospital between 1969 and 1996 with a diagnosis of ectopic pregnancy, non-gonococcal salpingitis, or gonococcal salpingitis. RESULTS: The frequencies of both non-gonococcal and gonococcal salpingitis increased steeply early in the period under study, rising to a peak in the early 1970s, then decreasing throughout the period except for the last 3 years when a slight increase was seen again. The frequency of ectopic pregnancy showed a steady increase, peaking in the late 1980s and early 1990s and then declining at the end of the study period. While the introduction of more sensitive pregnancy tests and programs for assisted fertility would increase the rate of ectopic frequency the decline during the 'nineties cannot be accounted for in this way. The peak of salpingitis cases in the early 'seventies seems to be mirrored exactly by the peak of ectopic pregnancies fifteen years later in the late 'eighties. CONCLUSION: The frequencies of salpingitis and of ectopic pregnancy can probably be used to estimate the incidence of preceding Chlamydia trachomatis. Thus the incidence of C. trachomatis has probably declined since the early 'seventies like that of N. gonorrheae.

Adult↗
PubMed1982

Chlamydial salpingitis.

The frequency of isolation of Chlamydia trachomatis from the cervix of patients with acute salpingitis has varied between 5% and 40%. A significant change in the titer of antibodies to C. trachomatis, as studied by microimmunofluorescence tests, has been found in 18% to 46% of patients with acute salpingitis. In salpingitis patients in whom C. trachomatis is isolated from the cervix, such a change in titer has been found in 31% to 54%. Patients with Chlamydia-associated salpingitis are generally young and do not appear severely ill. The erythrocyte sedimentation rate is generally higher in such patients than in women with salpingitis not associated with chlamydial infection, and the inflammatory reaction in the fallopian tubes is more severe than would normally be expected from the relatively benign clinical picture. The only reliable means of diagnosing chlamydial salpingitis is by laparoscopy. In chlamydial salpingitis, all layers of the tubal wall usually show an inflammatory infiltration. The mucosa is destroyed either totally or patchily. Experimental infections in grivet monkeys have fulfilled Koch's postulates. Evidence is accumulating that post-chlamydial salpingitis is a major factor in tubal infertility.

Adult↗
PubMed1982

Acute salpingitis in the adolescent female.

Acute salpingitis is an important complication of sexually transmitted disease in young women and should be considered in the differential diagnosis of abdominal pain in all young women. Many organisms, in addition to N. gonorrhoeae, have been associated with this tubal infection giving support to polymicrobial etiology. However, the exact pathophysiologic role of these organisms needs to be clearly defined. The microbiology of acute salpingitis, through direct culture from the site of infection, the fallopian tubes, needs to be clearly elucidated. Early recognition and treatment of acute salpingitis is essential in preventing the major long-term problem, involuntary infertility. Curran has estimated the reproductive outcome for a cohort of adolescent women reaching reproductive age in 1970. By the year 2000, there will have been one episode of salpingitis for every two women; 15% will be hospitalized for salpingitis with over half of these women requiring major gynecologic surgery; 10% will be rendered nonsurgically sterile; and 3% will have experienced an ectopic pregnancy. Adolescent females may be more susceptible to upper genital tract infection than older women due to possible unique biologic characteristics and sexual behaviors. Prospective microbiologically controlled studies of women with salpingitis using laparoscopy need to be developed to evaluate treatment regimens. Until such studies are undertaken, diagnosis, treatment, and fertility in women with acute salpingitis will remain unsatisfactory.

Acute Disease↗
PubMed1985

Infections with Neisseria gonorrhoeae and Chlamydia trachomatis in women with acute salpingitis.

The value of cultural and serological procedures in diagnosing gonococcal and chlamydial infections was investigated in 85 women who had provisional diagnoses of pelvic inflammatory disease. The correlation between certain clinical variables and the absence or presence of such infections was also studied. In 46 the diagnosis of acute salpingitis was verified by laparoscopy. The laboratory and clinical findings in the patients with acute salpingitis were compared with those in the remaining 39 women in whom laparoscopy did not show signs of inflammation. Salpingitis was considered to be gonococcal if Neisseria gonorrhoeae was isolated or a fourfold or more change in titre of antibodies to gonococcus pilus antigen was found. The diagnosis of chlamydial salpingitis was based on the isolation of Chlamydia trachomatis, a fourfold or more change in titre of IgG antibodies to or from a titre of greater than or equal to 1/256, or the presence of IgG antibodies at a titre of greater than or equal to 1/512. Patients with chlamydial salpingitis had less severe symptoms but a more protracted course of disease than patients with gonococcal salpingitis or with acute salpingitis not associated with the two pathogens.

Acute Disease↗
PubMed1986

The occurrence of chlamydial and gonococcal salpingitis during the menstrual cycle.

We evaluated 104 women hospitalized with a diagnosis of acute salpingitis to compare the relationship between the menstrual cycle and onset of acute chlamydial and/or gonococcal salpingitis and acute salpingitis associated with other facultative aerobic and anaerobic bacteria. Neisseria gonorrhoeae was recovered from 42 women (40%), Chlamydia trachomatis from 28 (27%), and nongonococcal, nonchlamydial organisms only from the upper genital tract in 48 (46%). Among 37 cases with symptoms of acute salpingitis within seven days of onset of menses, 30 (81%) had chlamydial and/or gonococcal infection. Of 35 cases with onset after 14 days postmenses, 23 (66%) had nongonococcal, nonchlamydial organisms only. Of the 28 women with chlamydial infection, 17 (57%) had the onset of disease within one week from the first day of their last menstrual period. Similarly, 23 (55%) of gonococcal infections had onset of symptoms within one week from onset of menses. However, only seven (14%) of the women with nongonococcal, nonchlamydial salpingitis reported onset of symptoms within one week. The temporal pattern of onset of chlamydial or gonococcal acute salpingitis showed significant differences when compared with the time of onset for nongonococcal, nonchlamydial acute salpingitis.

Adolescent↗
PubMed1983

Follow-up of patients with tubo-ovarian abscess(es) in association with salpingitis.

The medical records of 143 patients hospitalized with a diagnosis of salpingitis over a five-year period were reviewed. Ninety-three patients had salpingitis without clinical evidence of a tubo-ovarian abscess. Seven (7.5%) of these women had surgical treatment; five of the seven were found to have tubo-ovarian abscesses which had not been detected clinically. Eighty-six of 93 (92.5%) patients with a clinical diagnosis of salpingitis and no abscess responded to medical management alone. Fifty patients had salpingitis and clinical evidence of a tubo-ovarian abscess(es); five of these patients had medical management only, 27 had medical treatment followed by surgery, and 18 had surgery initially before receiving antibiotics. There was a significant difference in age but not in parity between patients with evidence of a tubo-ovarian abscess that was managed medically and those who had surgery. There was no significant difference in surgical procedure performed, chronic symptoms, subsequent gynecologic surgery, or subsequent pregnancy among the groups with an abscess. There was a trend toward more surgical complications among women who had delayed surgical intervention for an abscess. Among women with a unilateral tubo-ovarian abscess, those who had a unilateral salpingo-oophorectomy had a higher pregnancy rate than those who received antibiotics alone. In this study, women with a tubo-ovarian abscess in association with salpingitis did not respond well to antibiotic treatment alone. This may be the most reliable way of distinguishing these patients from women with salpingitis alone or salpingitis in association with a tubo-ovarian inflammatory complex, who, as a group, did respond well to medical management alone.

Abscess↗