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Salpingitis is an
infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
causing
inflammation Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...
in the
Fallopian tubes The fallopian tubes, also known as uterine tubes, oviducts or salpinges (singular salpinx), are paired tubes in the human female that stretch from the uterus to the ovaries. The fallopian tubes are part of the female reproductive system. In ot ...
(also called ''salpinges''). It is often included in the umbrella term of pelvic inflammatory disease (PID), along with
endometritis Endometritis is inflammation of the inner lining of the uterus ( endometrium). Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge. It is the most common cause of infection after childbirth. It is also p ...
,
oophoritis Oophoritis is an inflammation of the ovaries. It is often seen in combination with salpingitis (inflammation of the fallopian tubes The fallopian tubes, also known as uterine tubes, oviducts or salpinges (singular salpinx), are paired tube ...
, myometritis, parametritis, and
peritonitis Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part or ...
.


Signs and symptoms

The symptoms usually appear after a menstrual period. The most common are: an abnormal smell and colour of
vaginal discharge Vaginal discharge is a mixture of liquid, cells, and bacteria that lubricate and protect the vagina. This mixture is constantly produced by the cells of the vagina and cervix, and it exits the body through the vaginal opening. The composition, amou ...
,
fever Fever, also referred to as pyrexia, is defined as having a body temperature, temperature above the human body temperature, normal range due to an increase in the body's temperature Human body temperature#Fever, set point. There is not a single ...
,
nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...
,
vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteri ...
,
bloating Abdominal bloating (or simply bloating) is a short-term disease that affects the gastrointestinal tract. Bloating is generally characterized by an excess buildup of gas, air or fluids in the stomach. A person may have feelings of tightness, press ...
, and frequent urination.
Pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...
may be felt during
ovulation Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized ...
, during periods, during sexual intercourse, on both sides of the abdomen, and lower back.


Causes

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.


Risk factors

It's been theorized that retrograde menstrual flow and the cervix opening during menstruation allows the infection to reach the Fallopian tubes. Other risk factors include surgical procedures that break the cervical barrier, such as: *endometrial biopsy *
curettage Curettage ( or ), in medical procedures, is the use of a curette (French, meaning scoop Mosby's Medical, Nursing & Allied Health Dictionary, Fourth Edition, Mosby-Year Book 1994, p. 422) to remove tissue by scraping or scooping. Curettages are ...
*
hysteroscopy Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix. It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention (operative hysteroscopy). Hysteroscope A hyst ...
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 Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and oral ...
(STD) 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

The bacteria most associated with salpingitis are: *''
N. gonorrhoeae ''Neisseria gonorrhoeae'', also known as ''gonococcus'' (singular), or ''gonococci'' (plural), is a species of Gram-negative diplococci bacteria isolated by Albert Neisser in 1879. It causes the sexually transmitted genitourinary infection gon ...
'' *''
Chlamydia trachomatis ''Chlamydia trachomatis'' (), commonly known as chlamydia, is a bacterium that causes chlamydia, which can manifest in various ways, including: trachoma, lymphogranuloma venereum, nongonococcal urethritis, cervicitis, salpingitis, pelvic infla ...
'' *'' Mycoplasma'' *'' Staphylococcus'' *''
Streptococcus ''Streptococcus'' is a genus of gram-positive ' (plural ) or spherical bacteria that belongs to the family Streptococcaceae, within the order Lactobacillales (lactic acid bacteria), in the phylum Bacillota. Cell division in streptococci occurs ...
'' However, salpingitis is usually polymicrobial, involving many kinds of pathogens such as ''
Ureaplasma urealyticum ''Ureaplasma urealyticum'' is a bacterium belonging to the genus ''Ureaplasma'' and the family Mycoplasmataceae in the order Mycoplasmatales. This family consists of the genera ''Mycoplasma'' and ''Ureaplasma''. Its type strain is T960. There are ...
'', and
anaerobic Anaerobic means "living, active, occurring, or existing in the absence of free oxygen", as opposed to aerobic which means "living, active, or occurring only in the presence of oxygen." Anaerobic may also refer to: * Anaerobic adhesive, a bonding a ...
and
aerobic Aerobic means "requiring air," in which "air" usually means oxygen. Aerobic may also refer to * Aerobic exercise, prolonged exercise of moderate intensity * Aerobics, a form of aerobic exercise * Aerobic respiration, the aerobic process of cel ...
bacteria.


Diagnosis

Salpingitis may be diagnosed by pelvic examination, blood tests, and/or a
vaginal In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hyme ...
or cervical swab.


Types

Salpingitis can be acute, chronic, or subclinical.


Epidemiology

Approximately one in fourteen untreated
Chlamydia Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium '' Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear they may occur only several we ...
infections will result in salpingitis. 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. Salpingitis has a higher incidence among members of lower socioeconomic classes. However, this is thought of 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

For those affected, 20% need hospitalization. For those aged 15–44 years, 0.29 per 100,000 die from salpingitis. One in six cases of salpingitis will lead to infertility. 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. 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. Other complications are: *Infection of ovaries and uterus *Infection of sex partners *An abscess on the ovary *Internal scars resulting in
Fitz-Hugh–Curtis syndrome Fitz-Hugh–Curtis syndrome is a rare complication of pelvic inflammatory disease (PID) involving liver capsule inflammation leading to the creation of adhesions. The condition is named after the two physicians, Thomas Fitz-Hugh, Jr and Arthur Ha ...
of the liver


Treatment

Salpingitis is most commonly caused by bacteria and typically treated with
antibiotics An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention o ...
.


In other animals

'' E. coli'', '' Gallibacterium'' and other bacteria can cause salpingitis in chickens and other
poultry Poultry () are domesticated birds kept by humans for their eggs, their meat or their feathers. These birds are most typically members of the superorder Galloanserae (fowl), especially the order Galliformes (which includes chickens, quails, a ...
. This can result in lower egg production.
Dairy cows Dairy cattle (also called dairy cows) are cattle bred for the ability to produce large quantities of milk, from which dairy products are made. Dairy cattle generally are of the species '' Bos taurus''. Historically, little distinction was m ...
can also have salpingitis.


References


External links

{{Diseases of the pelvis, genitals and breasts Inflammatory diseases of female pelvic organs