salpingitis

(săl″pĭn-jī′tĭs)

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[Gr. salpinx, tube, + itis, inflammation]
Inflammation of a fallopian tube, usually as a result of a sexually transmitted infection. The prognosis is affected by the virulence of the organism, degree of inflammation, and promptness of treatment. The long-term consequences of the infection may include scarring of the fallopian tubes and infertility.

ETIOLOGY
The most common causative organisms are Neisseria gonorrhoeae and Chlamydia trachomatis. Additional microbes include Staphylococcus aureus, Escherichia coli, and other aerobic and anaerobic bacilli and cocci. Although common elsewhere, tubercular salpingitis is rare in the U.S.; it is most likely to be present in immunosuppressed women and some immigrant populations. Postpartum salpingitis often results from the upward migration of commensal vaginal streptococci.

SYMPTOMS
Although the disease may be asymptomatic, the patient often presents with signs of an acute pelvic infection. Complaints include unilateral or bilateral pelvic or lower abdominal pain, fever, and chills.

EXAMINATION
If an abscess has formed, bimanual palpation or ultrasonography may reveal a tender adnexal mass.

TREATMENT
Empirical antibiotic therapies may include fluoroquinolones or combination therapies using tetracycline derivatives and cephalosporins. Care must be taken to avoid using fluoroquinolones or tetracyclines in pregnancy. Bedrest and analgesics assist in pain management.

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