Salpingitis is an acute inflammation of the fallopian tubes caused by bacterial infection, which can lead to scarring, adhesions, and infertility.
Etiology
- Sexually transmitted
infections (STIs)
- Neisseria
gonorrhoeae
- Chlamydia
trachomatis
- Mycoplasma
hominis
- Ascending infections from
the vagina or cervix
- Post-abortion or postpartum
infections
- Tuberculous infection
(Mycobacterium tuberculosis)
- Spread from adjacent organs
- Appendicitis
- Pelvic peritonitis
Pathological Changes
·
Acute Salpingitis:
- Tube appears swollen, thickened, and edematous
- Hyperemia and seropurulent exudate
- Mucosal edema with
acute inflammatory reaction
- In severe cases: tubo-ovarian abscess formation
·
Chronic Salpingitis:
- Thickening of
the fallopian tube wall
- Accumulation of mucus
or pus in the tubes → Hydrosalpinx or Pyosalpinx
- Repeated attacks cause fibrosis and endosalpingitis
Clinical Features
·
Acute Salpingitis
- Lower abdominal
pain (bilateral)
- Fever, nausea,
vomiting
- Abnormal vaginal
discharge (purulent, copious)
- Dysmenorrhea and
menorrhagia
- Dyspareunia
(painful intercourse)
- Pelvic
tenderness on bimanual examination
·
Chronic Salpingitis
- Persistent lower
abdominal pain
- Menstrual
irregularities
- Pelvic heaviness
and tenderness
- Tubal
obstruction leading to infertility
Diagnosis
- Complete blood count (CBC) – Leukocytosis
- Erythrocyte sedimentation
rate (ESR) and C-reactive protein (CRP) – Elevated
- Pelvic ultrasound – To detect tubo-ovarian abscess
- Laparoscopy – Direct visualization of inflamed
tubes
- Culdocentesis – Aspiration of peritoneal fluid
Complications
- Infertility due to tubal blockage
- Ectopic pregnancy
- Tubo-ovarian abscess
formation
- Chronic pelvic pain
- Septicemia (systemic
infection)
Treatment & Management
1. Antibiotic Therapy
·
Empirical treatment (before
culture results):
- Ceftriaxone 250 mg IM
single dose
- Doxycycline 100 mg PO BID
for 14 days
- Metronidazole 500 mg PO BID
for 14 days
·
For severe cases (IV therapy):
- Ceftriaxone 1g IV BID
- Gentamicin 80 mg IV
- Metronidazole 500 mg IV
2.
Surgical Management
- Drainage of tubo-ovarian abscess
- Salpingectomy (if fallopian
tubes are severely damaged)
3.
Prevention Strategies
- Safe sexual practices (use
of condoms)
- Routine STI screening
- Prompt treatment of genital
infections
Keynote
Symptoms of Salpingitis
1.
Severe lower abdominal pain, usually
bilateral
2.
Purulent vaginal discharge
3.
Fever, nausea, and vomiting
4.
Pain during intercourse
(dyspareunia)
5.
Irregular or excessive vaginal
bleeding
1. Apis Mellifica
Indications:
- Acute salpingitis with
burning, stinging pain.
- Swelling, tenderness, and
ovarian involvement.
Keynote Symptoms:
- Severe burning pain with ovarian
swelling.
- Worse from heat, better with cold
applications.
- Frequent urination with stinging pain.
- Sudden onset of inflammation with
edema.
- Restlessness and anxiety.
2. Belladonna
Indications:
- Acute, sudden onset of
fallopian tube inflammation.
- High fever with throbbing
pain.
Keynote Symptoms:
- Sudden, violent pain in the lower
abdomen.
- Fever with flushed face and dry skin.
- Increased sensitivity to touch.
- Throbbing sensation with congestion.
- Symptoms worsen in the afternoon and
at night.
3. Lachesis
Indications:
- Chronic salpingitis with
purulent discharge.
- Left-sided ovarian and tube
involvement.
Keynote Symptoms:
- Left-sided pelvic pain, worse before
menstruation.
- Purulent, offensive vaginal discharge.
- Symptoms worsen with tight clothing.
- Feeling of congestion and fullness in
the pelvis.
- Sensitive to touch and heat.
4. Mercurius Solubilis
Indications:
- Salpingitis with
foul-smelling discharge and ulcers.
- Involvement of cervix and
vaginal walls.
Keynote Symptoms:
- Greenish, purulent vaginal discharge.
- Excessive sweating with a foul odor.
- Pain worse at night.
- Swollen glands and lymph nodes.
- Metallic taste in the mouth.
5. Hepar Sulphur
Indications:
- Suppurative salpingitis with
pus formation.
- Sensitive to touch, extreme
chilliness.
Keynote Symptoms:
- Extreme sensitivity to touch.
- Thick, yellow pus discharge.
- Symptoms worsen with cold air or
exposure.
- Irritability and anger with pain.
- Better from warmth and covering up.
