Salpingitis is inflammation and infection within the fallopian tubes, the muscular ducts that transport the egg from the ovary to the uterus. This infection is a specific form of Pelvic Inflammatory Disease (PID). It can affect one or both fallopian tubes. Without prompt treatment, the resulting inflammation can quickly cause swelling, fluid accumulation, and significant structural damage, impairing the tubes’ normal function.
Understanding the Causes
Salpingitis usually begins when bacteria ascend from the lower genital tract into the uterus and then the fallopian tubes. The vast majority of cases are caused by sexually transmitted bacterial infections. The most frequent culprits are Chlamydia trachomatis and Neisseria gonorrhoeae, the pathogens responsible for chlamydia and gonorrhea. These organisms often colonize the cervix and spread silently, causing inflammation that may go unnoticed. Less commonly, salpingitis can arise from non-sexually transmitted bacteria or after certain medical procedures, such as an endometrial biopsy, hysteroscopy, or the insertion of an intrauterine device (IUD).
Recognizing the Symptoms
Salpingitis symptoms vary widely; sometimes, the infection causes damage undetected because there are no noticeable symptoms. When symptoms occur, they are categorized as acute or chronic. Acute salpingitis involves a sudden onset of severe manifestations, often including fever, intense lower abdominal or pelvic pain, and sometimes nausea or vomiting. Chronic salpingitis involves milder symptoms that persist over a longer period. These may include dull lower back pain, discomfort during sexual intercourse, or pain during ovulation or menstruation. An abnormal vaginal discharge, which may be foul-smelling or yellowish, is another common sign of active infection, often appearing shortly after the menstrual period.
Diagnostic Procedures
Diagnosing salpingitis involves a combination of clinical evaluation, laboratory analysis, and imaging studies. A healthcare provider performs a physical examination, including a pelvic exam, to check for tenderness around the fallopian tubes and ovaries and to look for abnormal discharge. Laboratory tests include blood and urine samples to check for markers of infection and inflammation, such as elevated white blood cell counts. Swabs are taken from the cervix and vagina to identify specific bacteria, like Chlamydia or Gonorrhea, which guides antibiotic treatment. Imaging often involves a transvaginal or abdominal ultrasound to visualize pelvic organs and detect signs of inflammation, fluid accumulation, or masses near the fallopian tubes.
Treatment and Recovery
The immediate goal of treatment is to eliminate the bacterial infection using broad-spectrum antibiotics. Since salpingitis is often caused by a mix of bacteria, treatment regimens involve a combination of medications effective against the most likely pathogens, including Chlamydia and Gonorrhea. A common outpatient regimen includes an antibiotic injection, such as ceftriaxone, followed by a two-week course of oral antibiotics, often including doxycycline and metronidazole. All recent sexual partners must also be tested and treated to prevent reinfection. In severe cases, such as high fever, pregnancy, or abscess formation, hospitalization may be necessary for intravenous antibiotics. Surgery is sometimes required to drain pus-filled pockets, known as tubo-ovarian abscesses, or to address significant scarring.
Long-Term Health Consequences
Untreated salpingitis can lead to serious, lasting health issues due to scar tissue formation within the fallopian tubes. This scarring permanently alters the tubes’ internal structure, leading to chronic pelvic pain that persists after the infection clears. This pain is often attributed to adhesions, which are bands of scar tissue causing organs to stick together. A major concern is tubal factor infertility, which occurs when damaged or blocked fallopian tubes prevent the egg and sperm from meeting. The risk of infertility is approximately 11% after one episode, rising dramatically with subsequent infections. Furthermore, scarred tubes increase the risk of ectopic pregnancy, where a fertilized egg implants outside the uterus, most often in the tube itself, which is a life-threatening medical emergency.