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Results for “Salpingitis”

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At least 19 recordsLinked to original sources

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↗

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↗

PubMed1989

Serovars of Chlamydia trachomatis causing postabortion salpingitis.

In a previously reported investigation, 69 women with genital chlamydial infection following legal abortion were studied prospectively. Ten cases of postabortion salpingitis and 16 cases of endometritis were identified. To ascertain whether some serovars of Chlamydia trachomatis are particularly likely to initiate an infection in the fallopian tubes and cause salpingitis, the chlamydial isolates from the patients with salpingitis and those isolates from cases free of infectious complications were serotyped using a panel of monoclonal antibodies. Six of the seven different serovars demonstrated in the symptom-free group were identified in salpingitis cases. The strains associated with salpingitis seemed to reflect the overall distribution of chlamydial serovars in the entire study group. The predominant serovars were E, F and H. A protective effect associated with chlamydial serum antibodies had previously been observed in salpingitis cases. Therefore, the antibody titres subdivided according to serovar were compared. No difference in the antibody response induced by the different serovars could be verified statistically, but the B-complex strains were associated with a higher antibody titre than the C-complex strains or the intermediate strains F and G.

Abortion, Legal↗

PubMed1978

Changes in the incidence of acute gonococcal and nongonococcal salpingitis. A five-year study from an urban area of central Sweden.

The incidence of acute gonococcal and nongonococcal salpingitis for a five-year-period (1970--74) was studied retrospectively in an urban area of central Sweden. The investigation was undertaken to see if the reported decrease of gonorrhoea in Sweden had been followed by a change in the incidence of gonococcal salpingitis--the most common complication of gonorrhoea. The study showed that the relative incidence of acute gonococcal salpingitis had decreased even more than urogenital gonorrhoea and these findings thus indicate a real decrease of gonorrhoea. At the same time there were more patients with nongonococcal salpingitis. During the period of the study the gonococcal complement-fixation test (GCFT) gave positive results in 40% to 80% of the patients with gonococcal salpingitis. The yield with this test was only 4% in patients with nongonococcal salpingitis during 1970 but it increased successively and was 23% in 1974. This increase was statistically highly significant (P less than 0.001).

Acute Disease↗

PubMed1989

Second look laparoscopy; evaluation of two different antibiotic regimens after treatment of acute salpingitis.

In order to have their diagnoses verified, etiology determined and treatment evaluated, 64 patients with suspected acute salpingitis (AS) underwent laparoscopy during which specimens were taken. The patients were referred to groups of either a mild (16/64), a moderate (26/64), or a severe (22/64) form of salpingitis. They were then randomized to one of two groups for treatment with either doxycycline/bensylpenicillin-procain (DC/BP) or trimethoprim-sulfamethoxazole (TMP-SMZ). The results were evaluated by second-look laparoscopy 3-6 months later when adhesions and tubal passage were looked for. Isolates from the cervix were culture positive for Chlamydia trachomatis (CT) in 36/64 (56%) (9/16 with a mild form, 13/26 with moderate form and 14/22 with a severe form of salpingitis). Neisseria gonorrhoeae (NG) was isolated from the cervix in 15/64 (23%) (5/16 with a mild form, 4/26 with a moderate form and 6/22 with a severe form of the disease). Oviductal cultures for CT were found in 12/64 (19%) (1/16 with a mild form, 4/26 with a moderate and 7/25 with severe form of salpingitis). Oviductal isolates for NG were found in 2/64 (13%) (2/16 from the group with a mild form of the disease). Second-look laparoscopy revealed totally occluded oviducts in two patients from the group with a severe form of salpingitis (one from each treatment group).

Acute Disease↗

PubMed1991

Salpingitis isthmica nodosa in female infertility and tubal diseases.

Salpingitis isthmica nodosa (SIN) is a condition of nodular thickening of the proximal Fallopian tube. The purpose of this study was to investigate the occurrence, distribution and frequency of SIN in Danish women salpingectomized because of tubal pregnancy or salpingitis and to correlate SIN with infertility, pregnancies, outcome of pregnancies, births, pelvic inflammatory disease and salpingitis. Sections from the isthmus were present in the specimens from 223 tubes from 193 patients and were analysed by the same pathologist. Originally, SIN was found in 12 patients but on re-examination, it was found in 24 patients. Ten women with SIN were bilaterally salpingectomized. Only one woman had SIN in both tubes. Women with SIN gave birth to as many children as women without SIN. After SIN had been diagnosed, no children were born, but this was not statistically different from the frequency of births in the non-SIN group after salpingectomy. Women with SIN had histological signs of salpingitis more often than women without SIN, but SIN complicated with salpingitis did not influence the number of children or tubal pregnancies. Women with SIN had a greater risk of two or more tubal pregnancies than women without SIN.

Adult↗

PubMed1979

Experimental acute salpingitis in grivet monkeys provoked by Chlamydia trachomatis.

Chlamydia trachomatis is a common cause of sexually transmitted diseases. Recently it has been shown that chlamydiae are also responsible for complications to such lower genital tract infections. In this study, isolates of C. trachomatis from the fallopian tubes of patients with acute salpingitis were inoculated direct into the fallopian tubes of two, and through the cervical canal into the uterine cavity of one grivet monkey. The experimental infections resulted in a self-limited acute salpingitis in the three animals. C. trachomatis was recovered from the monkeys 2 and 3 weeks post inoculation. As found at laparotomy, the infected tubes were swollen and reddened, and there was watery exudate in the abdominal ostia. Microscopically, cellular infiltrates--mainly lymphocytes--were seen in the mucosa, muscularis and subserosa of the tubes. Serologically, a primary antibody response with an IgM to IgG conversion was found. Salpingitis did not occur in a control monkey inoculated in the tubes with a medium lacking Chlamydia. The histological changes in the fallopian tubes of the infected monkeys were reminiscent of those described as being characteristic of "gonococcal" salpingitis in man. The fulfilment of Koch's postulates in the animal model used adds to the earlier evidence that C. trachomatis is capable of causing acute salpingitis in humans.

Acute Disease↗

PubMed1979

The intrauterine contraceptive device and acute salpingitis: a multifactor analysis.

From an indigent population hospitalized with acute salpingitis, 163 patients were compared with 222 control patients from the minor trauma section of the emergency room. Four factors were significantly different between cases and controls: race, type of contraception, number of sex partners, and previous history of salpingitis. A discriminate analysis based on a linear logistic equation demonstrated that each risk factor was independent rather than a reflection of another risk factor. Thus factors associated with race, IUD use, multiple sexual partners, and previous salpingitis increase the risk of salpingitis in the population studied.

Acute Disease↗

PubMed1978

Salpingitis in ovarian endometriosis.

A histologic study of 87 cases of ovarian endometriosis with salpingectomy revealed 29 cases (33%) in which the removed fallopian tubes showed chronic salpingitis. Tubal obstruction could be demonstrated in only one of these patients. Tubo-ovarian adhesions were found in 15 patients (17%) and in only 7 of these in association with salpingitis. Although the patients in the present series did not consult their physicians because of infertility, but rather for other symptoms related to pelvic endometriosis, the finding of chronic salpingitis in 33% of the cases suggests that salpingitis may play a role in the infertility associated with endometriosis, possibly through altered tubal secretion.

Acute Disease↗

PubMed1992

[Treatment of acute salpingitis with tetracycline/metronidazole with or without additional balneotherapy, Augmentin or ciprofloxacin/metronidazole: a second-look laparoscopy study].

110 patients suffering from laparoscopical verified salpingitis and desire for a baby, were treated with tetracycline (oxytetracycline or doxycycline; TC)/metronidazole (n = 67), augmentan (n = 22) or cipropfloxacin/metronidazole (n = 21). After an average period of 11.6 weeks, all patients underwent second-look laparoscopy with dye insufflation. In 34 patients treated with TC/metronidazole, the effects of additional physio-therapeutical measures were examined under conditions as they prevail in a Spa. 33 patients without balneotherapy served as controls. All the 4 groups were comparable (p greater than 0.05) in respect of mean age, percentage, share of nulliparous women, salpingitis gonorrhoica, contraceptive behaviour and also of the stage of salpingitis. All antibiotic regimens used resulted in a prompt decrease of inflammatory clinical signs after five days (temperature, blood sedimentation rate, leukocytes). Only 2 of 34 patients treated by additional cure at a Spa reported complaints, whereas complaints were reported by 14 of 33 control patients (p less than 0.01), 7 of 22 (p less than 0.01) treated with augmentan and to 7 of 21 (p less than 0.01) treated with ciprofloxacin/metronidazole. The tubal occlusion rates amounted to 33.3% (TC/metronidazole), 32.3% (TC/metronidazole and balneotherapy), 22.7% (augmentan) and 23.8% ciprofloxacin/metronidazole. The differences did not attain statistical significance (p greater than 0.05). With regard to adhesions, there were, likewise, no significant differences between findings at first laparoscopy and second look-laparoscopy, respectively. It is concluded, that additional physiotherapeutic measures, after antibiotic therapy of acute salpingitis, reduce the frequency of lower abdominal pain, but do not result in an improvement of tubal occlusion and reduction of adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1977

Chlamydia trachomatis infection in patients with acute salpingitis.

We examined the prevalence of Chlamydia trachomatis in the cervix and the fallopian tubes of patients with acute salpingitis. Cycloheximide-treated McCoy cells were used as the growth medium. For purposes of comparison, women with infections confined to the lower genital tract and women without signs of genital infections were also studied. C. trachomatis was isolated from the cervix in 19 of 53 patients with acute salpingitis, in one of 18 lower-genital-tract infections and in none of 12 without signs of genital infection. C. trachomatis was recovered from six of the 20 valid specimens from the fallopian tubes of the patients with acute salpingitis. Our results indicate that chlamydia is a common etiologic agent in acute salpingitis.

Acute Disease↗

PubMed1991

Acute chlamydial salpingitis with ascites and adnexal mass simulating a malignant neoplasm.

Chlamydia trachomatis is a well-known cause of acute and chronic salpingitis, accounting for approximately half of all cases of pelvic inflammatory disease. Typically, patients with acute chlamydial salpingitis present with acute lower abdominal pain, tenderness on bimanual pelvic examination, or vaginal discharge. We describe a case of acute chlamydial salpingitis with marked ascites and an adnexal mass that simulated a malignant neoplasm. Microscopically, a severe lymphofollicular salpingitis and a marked lymphofollicular hyperplasia of the omentum and retroperitoneal lymph nodes were found. Chlamydial inclusions in the fallopian tube epithelium were demonstrated by immunohistochemistry using a mouse monoclonal antibody to a genus-specific outer membrane lipoprotein. Chlamydial infection may cause marked ascites and a palpable adenexal mass and should be considered whenever marked chronic inflammation with a lymphofollicular hyperplasia involves the fallopian tube or other female genital tract sites.

Adnexa Uteri↗

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↗