Salpingitis
3154608
226095997
2008-07-16T20:23:14Z
92.195.95.11
/* Acute and chronic salpingitis */
{{Infobox_Disease |
Name = {{PAGENAME}} |
Image = Scheme female reproductive system-en.svg |
Caption = [[Fallopian tubes]] labeled at top center. |
DiseasesDB = 9748 |
ICD10 = {{ICD10|N|70||n|70}} |
ICD9 = {{ICD9|614.2}} |
ICDO = |
OMIM = |
MedlinePlus = |
eMedicineSubj = med |
eMedicineTopic = 2059 |
MeshID = |
}}
'''Salpingitis''' is an [[infection]] and [[inflammation]] in the [[fallopian tubes]]. It is often used synonymously with [[Pelvic inflammatory disease|PID]], although PID lacks an accurate definition and can refer to several diseases of the female upper [[genital tract]], such as [[endometritis]], [[oophoritis]], [[myometritis]], [[parametritis]] and infection in the [[pelvic peritoneum]]<ref name="emedicine"> [http://www.emedicine.com/MED/topic2059.htm/ emedicine.com] </ref>
. In contrast, salpingitis only refers to infection and inflammation in the fallopian tubes.
<ref name="emedicine"/>
==Acute and chronic salpingitis==
There are two types of salpingitis: Acute salpingitis and chronic salpingitis.
Acute salpingitis causes the fallopian tubes to become red and swollen. The inner walls get adhered to each other, causing a block in the tube. The fallopian tube can also get stuck to the surrounding intestine.
In contrast, the chronic salpingitis is milder, showing lesser symptoms. It often comes after an attack of acute salpingitis, and lasts longer than the former. <ref name="mamashealth"/> Chronic salpingitis may result in a [[hydrosalpinx]].
==Symptoms==
The symptoms usually appear after a menstrual period. The most common are:
*Abnormal smell and colour of vaginal discharge.
*Pain during ovulation
*Pain during sexual intercourse
*Pain coming and going in periods
*Abdominal pain
*Lower back pain
*[[Fever]]
*Nausea
*Vomiting
<ref name="mamashealth"/>
==Causes and pathophysiology==
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. <ref name="mamashealth"> [http://www.mamashealth.com/women/salpingitis.asp/ mamashealth.com] </ref>
===Risk factors===
It's been theorized that retrograde menstrual flow and that the [[cervix]] opens during menstruation allows the infection to reach the fallopian tubes.
Other risk factors include:
Surgical procedures, breaking the cervical barrier:
*endometrial biopsy
*[[curettage]]
*[[hysteroscopy]]<ref name="emedicine"/>
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:
*antibiotic treatment
*ovulation
*menstruation
*[[sexually transmitted disease]] (STD)
Finally, sexual intercourse may facilitate the spread of disease from vagina to fallopian tube. Coital risk factors are:
*Uterine contractions
*Sperm, carrying organisms upwards.
===Bacterial species===
The bacteria most associated with salpingitis are
*[[N. gonorrhoeae]]
*[[C. trachomatis]]<ref name="emedicine"/>
*[[Mycoplasma]]
*[[Staphylococcus]]
*[[Streptococcus]] <ref name="mamashealth"/>
However, salpingitis usually is [[polymicrobal]], involving many kinds of organisms. Other examples of organisms involved are:
*[[Ureaplasma urealyticum]]
*[[anaerobic]] and [[aerobic]] bacteria.
==Epidemiology==
Over one million cases of acute salpingitis are reported every year in the U.S., 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 aged 16-25, salpingitis is the most common serious infection. It affects approximately 11% of the female of reproductive age.<ref name="emedicine"/>
Salpingitis has a higher incidence among blacks and members of lower socioeconomic classes. However, this is thought of being an effect of earlier sex 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 aged 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==
For the affected, 20% need hospitalization.
Regarding patients aged 15-44 years, 0,29 per 100.000 dies from salpingitis.<ref name="emedicine"/>
However, salpingitis can also lead to infertility, because the eggs released in ovulation can't get contact with the sperm. Approximately 75.000-225.000 cases of infertility in the U.S. 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.<ref name="emedicine"/>
In addition, damaged oviducts increase the risk of [[ectopic pregnancy]]. Thus, if one has had salpingitis, the risk of a pregnancy to become ectopic is 7- to 10-fold as large. Every two ectopic pregnancies are due to a salpingitis infection.<ref name="emedicine"/>
Other complications are:
*Infection of ovaries and uterus <ref name="mamashealth"/>
*Infection of sex partners <ref name="mamashealth"/>
*An abscess on the ovary <ref name="mamashealth"/>
==Treatment==
Salpingitis is most commonly treated with [[antibiotics]]. <ref name="mamashealth"/>
Prompt treatment and Contact-tracing minimizes complications,
''Admition'''''Bold text''' for '''Blood Culture''' and '''Iv Antibiotics''' if very Unwell(eg,'''Cefoxitin''' 2gr/6hrls slow IV with '''doxycyclin''' 100 mg/12h PO) initially then '''Doxycyclin''' 100 mg /12 h PO with '''Metronidazol''' 400 mg 12h PO until 14 days can cover gonorrhea and chlamydia infection.
if less unwell '''Ofloxacin''' 400 mg/12 h PO and '''Metronidazole''' 400 mg/12 hr Po for 14 days.Trace contacts and ensure the patient and partner seek treatment is essential.
==Diagnosis==
By [[Pelvic examination]], blood tests and [[mucus swab]] a doctor can diagnose salpingitis.
==References==
<references/>
{{Diseases of the pelvis, genitals and breasts}}
[[Category:Gynecology]]
[[es:Salpingitis]]
[[pt:Salpingite]]
[[sv:Salpingit]]