gonococcal salpingitis

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 among other cultures, 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.