Hubbry Logo
SalpingitisSalpingitisMain
Open search
Salpingitis
Community hub
Salpingitis
logo
8 pages, 0 posts
0 subscribers
Be the first to start a discussion here.
Be the first to start a discussion here.
Salpingitis
Salpingitis
Salpingitis
View on Wikipedia
from Wikipedia
Salpingitis
Micrograph of acute and chronic salpingitis. H&E stain.
SpecialtyGynecology

Salpingitis is an infection causing inflammation in the fallopian tubes (also called salpinges). It is often included in the umbrella term of pelvic inflammatory disease (PID), along with endometritis, oophoritis, myometritis, parametritis, and peritonitis.[1][2]

Signs and symptoms

[edit]

The symptoms usually appear after a menstrual period. The most common are: an abnormal smell and colour of vaginal discharge, fever, nausea, vomiting, bloating, and frequent urination. Pain may be felt during ovulation, during periods, during sexual intercourse, on both sides of the abdomen, and lower back.[3]

Causes

[edit]

The infection usually has its origin in the vagina and ascends to the fallopian tube from there. Because the infection can spread via the lymph vessels, infection in one fallopian tube usually leads to infection of the other.[3]

Risk factors

[edit]

It's been theorized that retrograde menstrual flow and the cervix opening during menstruation allow the infection to reach the fallopian tubes.

Other risk factors include surgical procedures that break the cervical barrier, such as:

Another risk is factors that alter the microenvironment in the vagina and cervix, allowing infecting organisms to proliferate and eventually ascend to the fallopian tube:

Finally, sexual intercourse may facilitate the spread of disease from the vagina to the fallopian tube. Coital risk factors are:

  • Uterine contractions
  • Sperm, carrying organisms upward

Bacterial species

[edit]

The bacteria most associated with salpingitis are:[3]

However, salpingitis is usually polymicrobial, involving many kinds of pathogens such as Ureaplasma urealyticum, and anaerobic and aerobic bacteria.

Diagnosis

[edit]

Salpingitis may be diagnosed by pelvic examination, blood tests, and/or a vaginal or cervical swab.

Types

[edit]

Salpingitis can be acute, chronic, or subclinical.[4]

Epidemiology

[edit]

Approximately one in fourteen untreated chlamydia infections will result in salpingitis.[5]

Over one million cases of acute salpingitis are reported every year in the US, but the number of incidents is probably larger, due to incomplete and untimely reporting methods and that many cases are reported first when the illness has gone so far that it has developed chronic complications. For women age 16–25, salpingitis is the most common serious infection. It affects approximately 11% of females of reproductive age.[2]

Salpingitis has a higher incidence among members of lower socioeconomic classes. However, this is thought of as being an effect of earlier sexual debut, multiple partners, and decreased ability to receive proper health care rather than any independent risk factor for salpingitis.

As an effect of an increased risk due to multiple partners, the prevalence of salpingitis is highest for people age 15–24 years. Decreased awareness of symptoms and less will to use contraceptives are also common in this group, raising the occurrence of salpingitis.

Complications

[edit]

For those affected, 20% need hospitalization. For those aged 15–44 years, 0.29 per 100,000 die from salpingitis.[2]

One in six cases of salpingitis will lead to infertility.[4] Salpingitis can also lead to tubal factor infertility because the eggs released in ovulation cannot make contact with the sperm. Approximately 75,000-225,000 cases of infertility in the US are caused by salpingitis. The more times one has the infection, the greater the risk of infertility. With one episode of salpingitis, the risk of infertility is 8-17%. With 3 episodes of salpingitis, the risk is 40-60%, although the exact risk depends on the severity of each episode.[2]

Damaged oviducts from salpingitis increase the risk of an ectopic pregnancy by 7-10 fold. Half of ectopic pregnancies are due to a salpingitis infection.[2]

Other complications are:[3]

  • Infection of ovaries and uterus
  • Infection of sex partners
  • An abscess on the ovary
  • Internal scars resulting in Fitz-Hugh–Curtis syndrome of the liver[6]

Treatment

[edit]

Salpingitis is most commonly caused by bacteria and typically treated with antibiotics.

In other animals

[edit]

E. coli, Gallibacterium and other bacteria can cause salpingitis in chickens and other poultry.[7][8] This can result in lower egg production.[8] Dairy cows can also have salpingitis.[9]

References

[edit]
[edit]
Revisions and contributorsEdit on WikipediaRead on Wikipedia

Salpingitis

View on Grokipedia
from Grokipedia
Salpingitis is an inflammation of the fallopian tubes, the structures that connect the ovaries to the , most commonly resulting from a bacterial infection that ascends from the lower genital tract. It is a primary component of , a broader spectrum of upper genital tract infections that can also involve the , ovaries, and surrounding tissues. This condition predominantly affects sexually active women of reproductive age, with an estimated 1 million cases of related PID occurring annually in the United States. Salpingitis can be classified as acute or chronic, and further categorized by etiology such as gonococcal or nongonococcal. The etiology of salpingitis is primarily infectious, primarily associated with sexually transmitted pathogens such as and . Other contributing bacteria may include anaerobes from , , or , particularly in polymicrobial infections. Risk factors include multiple sexual partners, young age (peaking in women aged 15-25), use of intrauterine devices, recent or , and douching, which can facilitate bacterial ascent during or other cervical barrier disruptions. While most cases are acute and linked to sexually transmitted infections, rare non-infectious forms can arise from congenital anomalies or post-surgical complications. Symptoms of salpingitis often include bilateral lower abdominal or , abnormal (typically purulent or foul-smelling), (painful intercourse), (painful urination), and irregular menstrual bleeding, though some cases may be , leading to delayed . Fever, , and vomiting can occur in severe acute presentations, while chronic salpingitis may manifest as persistent . is primarily clinical, relying on findings such as , uterine or adnexal tenderness, and mucopurulent cervical discharge, supported by laboratory tests like nucleic acid amplification for and , elevated inflammatory markers (e.g., or ), and imaging such as transvaginal to detect tubal thickening or abscesses. In ambiguous cases, can confirm tubal inflammation with high specificity. If untreated, salpingitis can lead to serious complications, including tubal scarring and adhesions that impair fertility (with rates of 10-15% after one episode and up to 50% after three), (6-10 times higher risk), chronic , and tubo-ovarian abscesses requiring surgical intervention. Treatment involves empiric broad-spectrum antibiotics to cover likely pathogens, such as an intramuscular dose of (500 mg) plus oral (100 mg twice daily) and (500 mg twice daily) for 14 days in outpatient settings, or intravenous regimens for hospitalized patients with severe symptoms or abscesses. Early intervention is critical to prevent long-term sequelae, and sexual partners should be evaluated and treated to avoid reinfection. Prevention strategies emphasize safe sexual practices, including consistent use, routine screening for sexually transmitted infections in at-risk populations, and prompt treatment of lower genital tract infections.

Introduction

Definition

Salpingitis is the of the fallopian tubes, also known as the salpinges, which are paired structures in the that connect the ovaries to the . This condition is typically bilateral and arises from an ascending originating in the lower genital tract, allowing pathogens to travel upward through the reproductive organs. The fallopian tubes measure approximately 10-12 cm in length and consist of key anatomical features, including the fimbriae—finger-like projections at the ovarian end that capture the ovum—and the , a narrower segment near the uterine junction with a thick muscular wall. These structures facilitate egg transport and fertilization while providing a pathway vulnerable to inflammatory processes. As a primary manifestation of (PID), salpingitis specifically targets tubal inflammation but is encompassed within the broader PID category, which involves infection of multiple pelvic reproductive organs. While PID can affect the , ovaries, and surrounding tissues, salpingitis denotes the tubal involvement that often drives complications such as or . The term "salpingitis" derives from the Greek word salpinx, meaning "," reflecting the tube's shape with its flared fimbriated end, combined with the -itis indicating . Common infectious causes include sexually transmitted bacteria such as and .

Classification

Salpingitis is classified temporally into acute and chronic forms based on the duration and nature of the inflammatory process. Acute salpingitis presents with sudden onset and severe symptoms, typically as part of (PID), and is characterized by marked swelling and . Chronic salpingitis, often a of untreated or recurrent acute episodes, involves milder, persistent lasting months to years, leading to scarring, , and adhesions. Etiologically, salpingitis is predominantly infectious, with subtypes distinguished by the causative pathogens. Gonococcal salpingitis results from infection, often presenting acutely with purulent discharge. Chlamydial salpingitis, caused by , tends to be more insidious and is a leading cause of tubal infertility. Polymicrobial salpingitis involves mixed aerobic and anaerobic bacteria, such as and species, commonly ascending from the lower genital tract. Non-infectious salpingitis is rare and may arise from post-surgical complications, such as chemical irritation following , or iatrogenic factors like intrauterine device insertion. Morphologically, salpingitis can lead to structural alterations of the fallopian tubes, such as and pyosalpinx. involves distal tubal dilation filled with sterile , representing a late-stage resolution of obstruction from prior . Pyosalpinx is an acute accumulation of pus within the distended tube, with thickened walls and intense . Salpingitis isthmica nodosa, a condition associated with previous salpingitis, features nodular diverticula-like outpouchings of the tubal into the myosalpinx, primarily in the isthmic region, and is linked to and risk. Clinical staging of salpingitis historically aligned with older PID severity assessments, such as the 1982 Gainesville system for acute cases, which categorizes disease complexity across five stages to guide therapy: Stage I (acute endometritis-salpingitis without ), Stage II ( with ), Stage III (acute with superimposed tubal occlusion or tuboovarian complex), Stage IV (tuboovarian has ruptured), and Stage V (repository category for other etiologic agents emulating acute ). However, modern guidelines, such as those from the CDC, emphasize empirical treatment based on clinical severity indicators like adnexal tenderness and systemic signs, without requiring such staging or laparoscopic confirmation.

Pathophysiology and Etiology

Pathophysiology

Salpingitis primarily develops through an ascending pathway, where pathogens from the lower genital tract, such as the or , migrate to the lumen, often facilitated by disruptions in the cervical mucus barrier or mucosal integrity during or . This ascent is polymicrobial in nature, involving both sexually transmitted and endogenous flora, leading to that progresses to salpingitis. Host factors play a critical role in disease progression, including immune evasion mechanisms by that allow intracellular survival and delayed detection. Genetic variations, such as polymorphisms in (TLR) genes, further compromise innate immunity, promoting persistent infection and eventual tubal occlusion through formation. The inflammatory cascade begins with acute infiltration into the tubal mucosa, triggered by bacterial lipopolysaccharides, resulting in , hyperemia, and accumulation within the lumen. This is amplified by pro-inflammatory cytokines, including interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-α), which recruit additional immune cells and induce endothelial activation, leading to and tissue damage. In chronic cases, unresolved inflammation progresses to , with proliferation and deposition causing permanent scarring and adhesions. Non-infectious mechanisms of salpingitis include ischemic from compromised tubal blood supply, often secondary to torsion or vascular occlusion, which triggers hypoxic tissue injury and subsequent fibrotic adhesions. Traumatic , such as that following insertion or surgical procedures, can also initiate a sterile inflammatory response via mucosal disruption, promoting serosal adhesions and tubal without microbial involvement.

Causes

Salpingitis is predominantly caused by infectious agents that ascend from the lower genital tract to the fallopian tubes. The most common etiologic agents are sexually transmitted infections, particularly (gonorrhea) and (chlamydia), which are implicated in approximately 50% of acute cases of (PID) involving salpingitis. These pathogens initiate an ascending , often leading to tubal inflammation if untreated. In many instances, salpingitis results from polymicrobial infections involving , especially in cases associated with postpartum or post-abortion scenarios. Anaerobic bacteria such as Bacteroides fragilis and species, along with facultative anaerobes like and , contribute to about 15-40% of cases, often exacerbating tissue damage through synergistic effects. Other facultative pathogens, including and , may also participate in these mixed infections. Rare infectious causes include , which leads to chronic granulomatous salpingitis in genital , particularly in endemic regions. Fungal infections, such as those caused by species, are uncommon but associated with (IUD) use, resulting in indolent pelvic . , an emerging pathogen, has been linked to nongonococcal, nonchlamydial PID and salpingitis. Viral etiologies are exceptional; for example, can cause , though this is infrequently documented. Additionally, has been linked to inflammation in isolated reports. Non-infectious causes of salpingitis are infrequent and include exacerbation of latent pelvic infections during with contrast media, leading to salpingitis or pelvic . Rare non-infectious causes include congenital tubal malformations.

Risk Factors

Salpingitis, as a component of (PID), is influenced by several modifiable and non-modifiable risk factors that increase susceptibility to ascending genital tract infections. Behavioral risks play a significant role, including having multiple sexual partners, which heightens exposure to sexually transmitted infections (STIs) capable of causing salpingitis. Unprotected intercourse, particularly without condom use, further elevates this risk by facilitating STI transmission. A history of STIs, such as chlamydia or gonorrhea, is strongly associated with recurrent episodes, as prior infections can damage mucosal barriers. Medical history contributes substantially, with a prior diagnosis of PID markedly increasing the likelihood of salpingitis due to residual tubal scarring. Use of an (IUD), especially within the first three weeks post-insertion, is linked to a transient elevated risk, potentially from introduced bacteria during placement. Recent gynecological procedures, such as induced abortion or , can also predispose individuals by providing a pathway for microbial ascent. Demographic factors include younger age, with peak incidence occurring between 15 and 24 years, attributed to higher rates of sexual activity and STI acquisition in this group. is associated with increased risk, often due to limited access to timely healthcare and preventive services. Other factors encompass smoking, which impairs in the reproductive tract and promotes bacterial persistence. Vaginal douching disrupts the normal , facilitating overgrowth of pathogenic bacteria that can ascend to the fallopian tubes.

Clinical Presentation

Signs and Symptoms

Salpingitis, as a component of (PID), typically presents with acute lower that can be unilateral or bilateral, often described as cramping or aching in nature. Patients frequently report , or pain during intercourse, abnormal that is purulent or mucopurulent with an unpleasant odor, (painful urination), and irregular menstrual bleeding. Up to 50% of cases may be . Systemic manifestations include fever, sometimes accompanied by chills, nausea, and vomiting, particularly in more severe cases. On , is a hallmark finding, elicited during bimanual , along with uterine and adnexal tenderness. Adnexal masses may be palpable in cases involving tubal swelling or early abscess formation. In chronic or recurrent salpingitis, symptoms may include persistent or recurrent and . These manifestations can persist for months or years, reflecting ongoing or sequelae from prior episodes.

Diagnosis

Clinical Evaluation

The clinical evaluation of suspected salpingitis begins with a detailed history taking to identify risk factors and contextualize symptoms. Clinicians assess the patient's sexual history, including the number of partners, recent changes in sexual activity, condom use, and history of sexually transmitted infections (STIs), as these are key risk factors for ascending genital tract infections leading to salpingitis. Gynecological patterns are reviewed, such as menstrual irregularities, abnormal vaginal bleeding, or dyspareunia, alongside any recent gynecological procedures like intrauterine device insertion, which can increase infection risk within three weeks. Prior STI screening results and partner symptoms are also queried to gauge exposure likelihood. Physical examination follows, focusing on pelvic assessment to detect tenderness indicative of . A speculum examination is performed to evaluate for cervical erythema, friability, or , which supports the of upper genital tract involvement. Bimanual is essential, checking for uterine, adnexal, or , often elicited by gentle manipulation during the exam; the presence of such tenderness in a sexually active with lower abdominal pain raises suspicion for salpingitis as part of (PID). Vital signs are assessed to determine disease severity and guide management decisions. Fever exceeding 38.3°C (101°F) or may signal systemic involvement, prompting consideration for hospitalization if accompanied by severe symptoms. Presumptive relies on clinical criteria, such as the modified Centers for Disease Control and Prevention (CDC) PID criteria, which include minimum standards like , uterine tenderness, or adnexal tenderness in the absence of another identifiable cause. Additional supportive findings, such as elevated or abnormal discharge observed during exam, increase specificity, with the overall clinical having a positive predictive value of 65%–90% for histologically confirmed salpingitis compared to . These criteria enable empiric treatment initiation in at-risk patients presenting with symptoms like .

Diagnostic Tests

Diagnosis of salpingitis relies on a combination of laboratory, imaging, and invasive procedures to confirm inflammation of the fallopian tubes and identify potential infectious etiologies. Laboratory tests provide initial evidence of infection and inflammation, while imaging and invasive methods offer more direct visualization and confirmation. Laboratory evaluation typically includes a complete blood count to assess for elevated white blood cell (WBC) counts, indicating systemic infection or inflammation. Inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are often measured, with elevations supporting the presence of acute inflammation. Nucleic acid amplification tests (NAAT) performed on cervical or vaginal swabs are used to detect common pathogens like Chlamydia trachomatis and Neisseria gonorrhoeae, enhancing diagnostic specificity when positive. Imaging modalities aid in visualizing tubal abnormalities without invasive intervention. Transvaginal ultrasound is commonly employed to identify tubal thickening greater than 5 mm, fluid-filled tubes, free pelvic fluid, or tubo-ovarian complexes suggestive of salpingitis. For chronic cases, (MRI) can depict tubal wall enhancement, , or adhesions, providing detailed assessment of persistent . assesses tubal patency and may reveal blockages or irregularities in chronic salpingitis, often performed in the context of evaluation. Invasive procedures offer definitive diagnosis. Laparoscopy serves as the gold standard with high (>90%), allowing direct visualization of tubal hyperemia, , or purulent to confirm salpingitis. Endometrial biopsy correlates with salpingitis by detecting concurrent , present in approximately 85% of cases with tubal involvement. Microbiologic cultures from , cervical swabs, or peritoneal aspirates during enable speciation beyond NAAT, identifying aerobic and anaerobic to guide .

Types

Salpingitis is classified into subtypes based on diagnostic findings that differentiate acute from chronic forms, primarily through and visualization techniques. Acute salpingitis is characterized by , swollen plicae, and formation (pyosalpinx), which can be identified via showing sausage-like cystic lesions or unilocular masses with incomplete , and revealing overt inflammation and adhesions. In contrast, chronic salpingitis presents with , thickened walls, and flattened epithelium, often detected by demonstrating scarring without active . Gonococcal salpingitis, caused by , is distinguished from non-gonococcal forms using , which reveals gram-negative intracellular diplococci in cervical or urethral samples with high sensitivity in symptomatic cases, and nucleic acid amplification tests (NAATs) for specific pathogen detection. Non-gonococcal salpingitis, typically involving or polymicrobial flora, lacks these diplococci on but is confirmed via NAATs targeting C. trachomatis or other microbes like . Tubo-ovarian abscess (TOA), a complication of salpingitis, is differentiated from simple salpingitis by computed tomography (CT) or showing complex, septated adnexal masses with thickened walls and restricted diffusion, whereas simple salpingitis appears as less complex tubal inflammation without discrete formation. Sterile salpingitis, often post-procedural, is identified by negative microbial cultures alongside a history of insertion, , or other gynecologic procedures, contrasting with infectious cases that yield positive cultures for pathogens like N. gonorrhoeae or C. trachomatis.

Treatment and Management

Medical Treatment

The medical treatment of salpingitis, which is typically managed as part of (PID), focuses on empirical therapy to cover common pathogens such as , , and anaerobes. Outpatient regimens recommended by the Centers for Disease Control and Prevention (CDC) include 500 mg intramuscularly as a single dose, followed by 100 mg orally twice daily for 14 days, plus 500 mg orally twice daily for 14 days. An alternative outpatient option is 2 g intramuscularly with probenecid 1 g orally as a single dose, combined with the same and regimen. For inpatient management, intravenous regimens are used, such as 1 g IV every 24 hours plus 100 mg orally or IV every 12 hours plus 500 mg IV every 12 hours. After clinical improvement within 24-48 hours, patients may transition to oral and to complete a total treatment duration of 14 days. Follow-up evaluation is advised within 72 hours of initiating to assess response; lack of improvement warrants hospitalization and reassessment. Sexual partners should be evaluated and treated empirically for and to prevent reinfection, with retesting for these infections recommended 3 months post-treatment. Supportive care includes analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for pain relief and for nausea. Hospitalization is indicated for severe illness, , suspected tubo-ovarian , inability to tolerate oral therapy, or failure of outpatient treatment. Recent 2020s guidelines highlight increasing azithromycin resistance in N. gonorrhoeae, leading to updated recommendations favoring ceftriaxone monotherapy for uncomplicated gonorrhea and influencing PID regimens to prioritize cephalosporins over alternatives like azithromycin due to resistance patterns exceeding 25% in some regions.

Surgical Interventions

Surgical interventions for salpingitis are reserved for cases to antibiotic therapy, including persistent , tubo-ovarian (TOA) formation, or chronic tubal obstruction contributing to . These procedures aim to eradicate , alleviate obstruction, and restore tubal patency where feasible, particularly in reproductive-age patients. Common indications include TOA larger than 7 cm, rupture, or lack of response to antibiotics within 72 hours, as well as severe chronic salpingitis with adhesions causing after failed medical management. For acute complications like TOA, initial minimally invasive drainage is preferred over immediate extirpative to preserve . Key procedures encompass laparoscopic salpingectomy for irreparably damaged tubes, where the affected is removed to halt ongoing infection or prevent recurrence. aspiration, often via image-guided or transvaginal approaches, is utilized for TOA drainage, with success rates exceeding 90% in unruptured cases when combined with antibiotics. Adhesiolysis, performed laparoscopically, addresses peritubal adhesions from chronic salpingitis to improve , with pregnancy rates ranging from 50-77% depending on adhesion severity. Minimally invasive options include for managing intrauterine adhesions secondary to chronic salpingitis, which can restore integrity and enhance outcomes when tubal factors are also addressed. In combined laparoscopy- approaches, pelvic adhesions and distortions are corrected, yielding improved conception rates in tubal factor infertility cases. Outcomes prioritize fertility preservation through unilateral procedures, with laparoscopic showing no significant detriment to and live birth rates of 39-59% in mild disease post-surgery. However, damage from salpingitis and surgery elevates risk, particularly after adhesiolysis or partial tube preservation. Surgical success in resolving acute TOA is high (over 93% with aspiration), though recurrence or persists in up to 15-20% of chronic cases.

Prevention

Preventing salpingitis, a key component of (PID), primarily involves strategies to reduce the risk of sexually transmitted infections (STIs) such as and , which are the most common causes. Consistent use of condoms during is a highly effective barrier method that significantly lowers the transmission of these pathogens. Additionally, routine screening for and is recommended annually for all sexually active women under 25 years of age and for older women at increased risk, such as those with multiple sexual partners or a history of STIs; early detection and treatment of asymptomatic infections prevent ascension to the upper genital tract. Patient education plays a crucial role in prevention, including counseling to avoid vaginal douching, which disrupts the and increases susceptibility to bacterial infections that can lead to salpingitis. Partner notification and treatment are essential components of STI management; infected individuals should inform recent sexual partners so they can seek testing and antibiotics, thereby interrupting transmission chains and reducing reinfection risk. For women using intrauterine devices (IUDs), which carry a small risk of introducing leading to salpingitis, routine prophylactic antibiotics at insertion are not recommended, including in high-risk cases. Screening for sexually transmitted s is advised for at-risk individuals prior to insertion, and the procedure should be delayed if an active is present. Meticulous aseptic technique during insertion and follow-up monitoring for signs of remain essential. Public health initiatives further support prevention through contact tracing programs, which facilitate partner identification and treatment to curb community spread of causative STIs. As of 2025, vaccination efforts against have advanced; in regions like the , the meningococcal group B (4CMenB, or Bexsero) is being offered to high-risk groups, providing approximately 30-40% protection against gonorrhea and potentially reducing associated salpingitis cases, though broader availability and a dedicated gonorrhea remain under development.

Complications and Prognosis

Complications

Untreated or recurrent salpingitis, a key component of (PID), can result in a range of acute complications that pose immediate threats to health. One of the most serious is the development of a tubo-ovarian , occurring in 15% to 35% of PID cases, where accumulates in the and adjacent , potentially leading to rupture if not addressed. may arise from bacterial spread to the , causing widespread abdominal inflammation and severe pain. can also develop in severe instances, particularly with abscess formation or delayed treatment, resulting in systemic that requires urgent hospitalization and broad-spectrum antibiotics. Reproductive complications represent a major long-term consequence of salpingitis, primarily due to scarring and distortion from . This scarring impairs ovum , leading to in approximately 10% to 15% of women after a single episode, with the risk escalating to 20% or higher after multiple occurrences. Furthermore, damaged fallopian tubes increase the likelihood of by 6- to 10-fold compared to the general , as the scarred tissue hinders normal implantation. Chronic sequelae often persist even after acute resolution, contributing to ongoing morbidity. Pelvic adhesions form as fibrous bands between organs, affecting up to one-third of women and causing that may interfere with daily activities. , in which the distal becomes obstructed and distended with , is another common chronic outcome, further compromising by blocking sperm-egg interaction. A rarer but notable complication is Fitz-Hugh-Curtis syndrome, involving perihepatitis where infection ascends to the liver capsule, forming violin-string adhesions and right upper quadrant pain in about 5% to 10% of salpingitis cases. In instances of tubo-ovarian abscess, surgical drainage or intervention may be necessary if antibiotics fail to resolve the condition.

Prognosis

The prognosis of salpingitis, often considered within the context of (PID), is generally favorable with prompt and appropriate management, though long-term reproductive and health outcomes vary based on disease severity, timeliness of intervention, and recurrence. Early antibiotic treatment significantly mitigates risks, reducing the incidence of tubal to approximately 10-15% following a single episode, compared to higher rates with delayed care. Recurrent episodes, however, lead to cumulative tubal damage, escalating risks to 30-35% after two episodes and over 50% after three or more. Fertility outcomes post-salpingitis improve markedly with timely treatment of acute cases; studies indicate conception rates of 75-90% among women attempting after a single episode managed with antibiotics, reflecting preserved patency in most instances. In contrast, chronic salpingitis, characterized by persistent low-grade , is associated with diminished due to scarring and adhesions. Specific complications such as further compound challenges in affected individuals. Recurrence rates for salpingitis range from 5-25% in the absence of preventive measures like partner treatment or barrier contraception, driven primarily by reinfection with sexually transmitted pathogens. Regarding , —a common —affects up to 33% of women post-salpingitis, but many cases resolve with targeted management including analgesics and follow-up care. Mortality remains rare, at less than 1%, typically arising from severe in untreated or complicated cases.

Epidemiology

Global Burden

Salpingitis represents a primary manifestation of (PID), accounting for the tubal involvement in 65–90% of clinically diagnosed PID cases when verified by laparoscopy. Globally, PID affects an estimated 1.05 million women in terms of point as of 2019, with an age-standardized rate of 53.19 per 100,000 population, though this rate has declined by an estimated annual percentage change of -0.50 from 1990 to 2019. Incidence rates vary markedly by setting, with high-income countries reporting 10–20 cases of PID per 1,000 reproductive-age women annually, equating to roughly 1–2% of this population. In low- and middle-income countries, rates are substantially higher due to elevated burdens and diagnostic challenges, though specific incidence data remain limited. The health impact of salpingitis as part of PID includes significant morbidity, with global prevalence of PID rising 36.66% in absolute terms from 1990 to 2019 despite the declining rate, reflecting and persistent risk factors. In the United States, PID is estimated to affect over 1 million women annually, leading to significant outpatient care and around 100,000–150,000 hospitalizations in recent years. Economic consequences are profound; direct medical costs for PID and its sequelae, including and , exceeded $1.88 billion annually in the late 1990s (1998 dollars), with lifetime per-person costs averaging around $2,150 when adjusted for and complications—figures that likely surpass $2 billion today when including lost from chronic sequelae. Trends indicate a decline in PID incidence in developed nations, attributed to widespread STI screening and antibiotic prophylaxis, as evidenced by decreasing age-standardized rates in global burden analyses. Post-2019, STI rates in the US showed a 13% increase over the decade but a small decline in 2023, potentially stabilizing PID trends; however, adolescent populations show concerning patterns driven by chlamydia and gonorrhea, with diagnoses increasing in prior years. These patterns highlight the need for targeted interventions to mitigate ongoing disparities in reproductive health burdens, particularly given data gaps in low- and middle-income countries.

Demographic Patterns

Salpingitis, a key component of (PID), affects females of reproductive age, with analogous conditions like arising in males due to ascending infections from the urinary tract. The age distribution of salpingitis shows a peak incidence among women aged 15-24 years, accounting for approximately 70% of cases in this demographic, reflecting heightened vulnerability during early sexual activity and exposure to sexually transmitted infections (STIs). Incidence rates are notably lower in adolescents under 15 and women over 35, and the condition is rare post-menopause due to the cessation of menstrual cycles and reduced STI risk in older populations. Geographically, salpingitis incidence is elevated in regions with high STI prevalence, such as and , where Western Sub-Saharan Africa reports the highest age-standardized prevalence rates of PID at over 116 per 100,000 women as of 2019. In contrast, experiences lower rates, attributed to robust STI screening and early intervention programs that have contributed to a decline in PID cases over recent decades. Socioeconomic factors exacerbate disparities in salpingitis occurrence, with low-income groups facing higher rates due to limited access to healthcare, delayed , and higher exposure to risk factors like untreated STIs. Studies indicate that measures of low , including and , correlate with increased PID risk (up to 1.5 times higher in high-poverty areas), underscoring the role of structural inequalities in .

In Other Animals

Occurrence in Veterinary Medicine

Salpingitis, an inflammation of the , is a notable reproductive disorder in , particularly affecting and contributing to subfertility and . In , it is frequently observed as a complication of , with nearly all cases (96%) associated with concurrent . The condition arises primarily from ascending bacterial infections originating in the lower genital tract, differing from cases which are more often linked to sexually transmitted pathogens; in ruminants, it is predominantly caused by opportunistic bacteria such as , , and . , the causative agent of bovine , also plays a role in reproductive , though direct oviduct involvement is less emphasized than abortion and ; this zoonotic pathogen links veterinary cases to risks through transmission via infected tissues or fluids. Prevalence in dairy cattle herds is significant, often contributing to up to 16% of infertility cases through concurrent reproductive tract inflammations like oophoritis and endometritis, with histopathological studies revealing bilateral salpingitis in over 90% of affected oviducts examined at slaughter. In pigs, salpingitis occurs less commonly but can manifest postpartum, typically as part of chronic endometritis or pyometra syndromes driven by bacterial ascent, such as E. coli or other coliforms, leading to oviductal inflammation and impaired egg transport. Horses experience salpingitis infrequently, usually from ascending infections following parturition or breeding, with bacterial agents like Chlamydia species implicated in rare cases of bilateral involvement that compromise fertility. These veterinary occurrences highlight etiology differences, with environmental and postpartum bacterial exposures predominating over sexually transmitted routes. The economic impact of salpingitis in stems from reduced breeding efficiency, including delayed conception, lower rates, and increased , which collectively account for substantial losses in and production through diminished yield and reproductive performance. In affected herds, the condition exacerbates , with oviductal impairing survival and oocyte maturation, thereby prolonging calving intervals and necessitating higher replacement rates. Zoonotic implications, particularly from Brucella abortus in , further amplify costs via regulatory testing, , and trade restrictions in endemic areas.

Clinical Features in Animals

In , salpingitis in female mammals such as often presents with reproductive failure, including and repeat breeding, alongside mucopurulent or purulent , fever, reduced appetite, and absence of estrus signs. These symptoms can lead to herd-level impacts like decreased rates and lowered yield in affected dairy operations. may manifest as restlessness or kicking at the flanks, particularly in acute cases associated with bacterial ascent from the . Diagnosis of salpingitis in mammals typically involves rectal to detect thickened or adherent oviducts, ultrasonography to visualize or fluid accumulation, and collection of uterine swabs for bacterial culture to identify pathogens like or species. Necropsy examinations in fatal cases reveal gross lesions such as reddened mucosa, increased vascularization, and purulent within the oviducts, often confirmed histologically by lymphocytic infiltration. In brucellosis-related salpingitis, serologic tests like assays support when combined with clinical . Management of salpingitis in mammals focuses on supportive care and targeted antimicrobial therapy, such as tetracyclines for brucellosis-associated cases, though efficacy is limited and often supplemented by infected animals to prevent herd spread. In outbreak scenarios, isolation of affected females and measures are essential, with in herds prompting from unaffected stock. In avian species, particularly poultry like chickens and ducks, clinical features include reduced egg production, production of soft-shelled or misshapen eggs, , , and occasionally respiratory distress if develops secondary to oviduct rupture. Oophorosalpingitis, involving both ovarian and al inflammation, is common in psittacine birds such as parrots, often caused by , and manifests as coelomic swelling, weight loss, and cessation of laying without overt external discharge. Avian diagnosis relies on ultrasound imaging to identify oviductal dilation or caseous material, radiographic evidence of soft-tissue masses, and necropsy for confirmatory gross like liquid or caseous in the ; bacterial cultures from cloacal or oviductal swabs guide identification. In psittacines, hematologic findings such as may support suspicion, with occasionally used for direct visualization in live birds. Management in birds involves broad-spectrum antibiotics like for E. coli-related cases, fluid therapy for , and of severely affected individuals in commercial flocks to curb outbreaks; supportive measures such as improved ventilation and hygiene prevent ascending infections. In pet psittacines, hormonal suppression with leuprolide may reduce reproductive stress exacerbating oophorosalpingitis.

References

  1. https://my.clevelandclinic.org/health/diseases/salpingitis
  2. https://www.cdc.gov/std/treatment-guidelines/pid.htm
  3. https://emedicine.medscape.com/article/275463-overview
  4. https://www.ncbi.nlm.nih.gov/books/NBK499959/
  5. https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
  6. https://www.aafp.org/pubs/afp/issues/2019/0915/p357.html
  7. https://www.osmosis.org/answers/salpingitis
  8. https://my.clevelandclinic.org/health/body/23184-fallopian-tubes
  9. https://www.merriam-webster.com/dictionary/salpingitis
  10. https://www.isuog.org/clinical-resources/patient-information-series/patient-information-gynecological-conditions/salpingitis.html
  11. https://www.ummhealth.org/health-library/acute-salpingitis
  12. https://www.ncbi.nlm.nih.gov/books/NBK563165/
  13. https://pubmed.ncbi.nlm.nih.gov/7091218/
  14. https://pmc.ncbi.nlm.nih.gov/articles/PMC3843151/
  15. https://pubmed.ncbi.nlm.nih.gov/25592078/
  16. https://pubmed.ncbi.nlm.nih.gov/24275271/
  17. https://emedicine.medscape.com/article/256448-overview
  18. https://www.hopkinsmedicine.org/health/conditions-and-diseases/mumps-in-adults
  19. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=511d1f64-5cb9-4baa-a123-96205467e59a
  20. https://pmc.ncbi.nlm.nih.gov/articles/PMC2563866/
  21. https://www.cdc.gov/mmwr/preview/mmwrhtml/00031002.htm
  22. https://medlineplus.gov/ency/article/000888.htm
  23. https://pmc.ncbi.nlm.nih.gov/articles/PMC11103142/
  24. https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/diagnosis-treatment/drc-20352600
  25. https://www.aafp.org/pubs/afp/issues/2006/0301/p859.html
  26. https://emedicine.medscape.com/article/404537-overview
  27. https://www.aafp.org/pubs/afp/issues/2002/0901/p872a.html
  28. https://emedicine.medscape.com/article/256448-workup
  29. https://academic.oup.com/humrep/article/28/6/1569/604182
  30. https://www.ncbi.nlm.nih.gov/books/NBK558903/
  31. https://www.ncbi.nlm.nih.gov/books/NBK448125/
  32. https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/treatment/
  33. https://www.cdc.gov/mmwr/volumes/69/wr/mm6950a6.htm
  34. https://www.ecdc.europa.eu/en/news-events/antimicrobial-resistance-gonorrhoea-rising-threat-treatment-efficacy
  35. https://emedicine.medscape.com/article/256448-treatment
  36. https://www.uptodate.com/contents/tubo-ovarian-abscess-management-and-complications
  37. https://emedicine.medscape.com/article/1848581-overview
  38. https://mdedge.com/obgyn/article/61155/laparoscopic-adhesiolysis
  39. https://pubmed.ncbi.nlm.nih.gov/33147492/
  40. https://pmc.ncbi.nlm.nih.gov/articles/PMC8415305/
  41. https://www.sciencedirect.com/science/article/abs/pii/S1553465017301425
  42. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/salpingectomy
  43. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/chlamydia-and-gonorrhea-screening
  44. https://www.cdc.gov/std/treatment-guidelines/screening-recommendations.htm
  45. https://academic.oup.com/epirev/article/24/2/109/534985
  46. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/adolescents-and-long-acting-reversible-contraception-implants-and-intrauterine-devices
  47. https://www.cdc.gov/mmwr/volumes/73/rr/rr7303a1.htm
  48. https://www.gov.uk/government/publications/meningococcal-b-menb-vaccination-against-gonorrhoea-guide/a-guide-to-the-meningococcal-b-vaccine-for-protection-against-gonorrhoea
  49. https://www.idph.state.il.us/public/hb/hbpid.htm
  50. https://radiopaedia.org/articles/pelvic-inflammatory-disease?lang=us
  51. https://www.ncbi.nlm.nih.gov/books/NBK499950/
  52. https://www.shadygrovefertility.com/article/fertility-facts-pelvic-inflammatory-disease/
  53. https://www.mdpi.com/2038-9582/13/3/23
  54. https://www.cureus.com/articles/388339-pelvic-inflammatory-disease-complicated-by-a-tubo-ovarian-abscess-a-case-report-and-literature-review
  55. https://pubmed.ncbi.nlm.nih.gov/12015517/
  56. https://www.orlandohealth.com/content-hub/how-pelvic-inflammatory-disease-can-affect-your-fertility/
  57. https://pmc.ncbi.nlm.nih.gov/articles/PMC10544469/
  58. https://www.acog.org/womens-health/faqs/pelvic-inflammatory-disease
  59. https://www.sciencedirect.com/science/article/abs/pii/S0029784499005517
  60. https://www.cdc.gov/sti-statistics/annual/index.html
  61. https://www.pedsurglibrary.com/apsa/view/Pediatric-Surgery-NaT/829148/6/Pelvic_Inflammatory_Disease
  62. https://www.glowm.com/article/heading/vol-12--infections-in-gynecology--pelvic-inflammatory-disease/id/420013
  63. https://pmc.ncbi.nlm.nih.gov/articles/PMC10510783/
  64. https://pmc.ncbi.nlm.nih.gov/articles/PMC6659645/
  65. https://www.sciencedirect.com/science/article/abs/pii/S0378432022000835
  66. https://www.merckvetmanual.com/reproductive-system/brucellosis-in-large-animals/brucellosis-in-cattle
  67. https://pmc.ncbi.nlm.nih.gov/articles/PMC6063340/
  68. https://clinicaltheriogenology.net/index.php/CT/article/view/9806
  69. https://www.intechopen.com/chapters/50439
  70. https://www.mdpi.com/2306-7381/11/2/66
  71. https://www.aphis.usda.gov/livestock-poultry-disease/cattle/bovine-brucellosis
  72. https://pmc.ncbi.nlm.nih.gov/articles/PMC9251803/
  73. https://pubmed.ncbi.nlm.nih.gov/26899897/
  74. https://www.merckvetmanual.com/poultry/disorders-of-the-reproductive-system-in-poultry/salpingitis-in-poultry
  75. https://pmc.ncbi.nlm.nih.gov/articles/PMC8232623/
  76. https://www.vetexotic.theclinics.com/article/S1094-9194%2802%2900026-9/fulltext
Add your contribution
Related Hubs
User Avatar
No comments yet.