Microbiology and pathogenesis of acute salpingitis as determined by laparoscopy: What is the appropriate site to sample?

Tubo-Ovarian Abscess in Older Women: Is the Woman’s Age a Risk Factor for Failed Response to Conservative Treatment?

“…Usually, as well as in the current study, these organisms have been isolated from TOA aspirates [2,7,16,23], and not only from the endocervix. The wellknown concept is that the important phase in the pathogenesis of TOA is the invasion and bacterial attachment of the upper genital tract [24,25], while the colonization of the lower tract is less important in the pathogenesis of TOA. Therefore, the significance of our finding, regarding the recovery of the microorganisms from the endocervix, is not readily apparent.…”

Long-Term Complications of Infection of the Female Genital Tract by Intracellular Sexually-Transmitted Microorganisms: A Review

“…Thus in the original series from Sweden, C. trachomatis was recovered from the fallopian tubes at laparoscopy in 30% of cases of PID (Mardh et al 1977); in subsequent reports the incidence of tubal isolation ranged from 24% in France (Henry-Suchet et al 1980) to nil in San Francisco (Sweet et al 1980). This variation probably reflects the difference in the severity of the disease rather than a variation in the rate of chlamydial infection; women undergoing laparoscopy for pelvic inflammatory disease in Sweden would seem on average to be less ill than those in the USA.…”

Pelvic Inflammatory Disease: Current notions

“…Pelvic inflammatory disease (PID) refers to clinical syndrome that represents a continuum of inflammationfromthecervixtotheendometrium,fallopiantubes,andcontiguous,pelvicstructure:cervicitis, endometritis,salpingitis,pelvic peritonitis,andtuboovarianabcess [I].Each year, approximately 1 million women in the United States experience an episode of symptomatic PID.Many women with PID have minimal or no symptoms [2].PID results from direct canalicular spread of microorganisms from the vagina or endocervix to the endometrium and fallopian tube mucosa [3].Both Neisseria gonorrhoeae and C.trachomatis commonly cause endocervitis.and clinical symptoms of acute PID develop in 10% to 40% of women with these infections who do not receive adequate treatment [4].In addition to N.gonorrhoeae and C.trachomatis.a wide variety of bacteria have been isolated from the upper genital tracts of women with acute symptomatic PID,including anaerobes,gram negative rods, streptococci, and mycoplasma [5].Many of these are the same microorganisms that are found in increased concentrations in the vaginas of women with bacterial vaginosis [6].Moreover, approximately one of four women with presumed uncomplicated lower genital tract gonococcal or chlamydial infection or bacterial vaginosis, or both, is found to have histological endometritis (subclinical PID) when evaluated by endometrial biopsy [3].Uncommonly, respiratory pathogens including Haemophilus influenza and Streptococcus pyogenes have also been isolated from the upper genital tracts of women with symptomatic PID [7,8].Gold standards for PID diagnosis often impractical to achieve in the outpatient setting. Endometrial biopsy showing changes consistent with PID,transvaginal ultrasound showing thickened fluid-filled tubes, and laproscopic evidence of PID [9].Treatment regimens should be effective against gonorrhea chlamydial and anaerobes [10].The paper reviews the risk factors, diagnosis and management of PID.…”