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There are two types of salpingitis: acute salpingitis and chronic salpingitis.
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 during periods
- Abdominal pain
- Lower back pain
- Fever
- Nausea
- Vomiting
- Bloating
The signs and symptoms of tubo-ovarian abscess (TOA) are the same as with pelvic inflammatory disease (PID) with the exception that the abscess can be found with magnetic resonance imaging (MRI), sonography and x-ray. It also differs from PID in that it can create symptoms of acute-onset pelvic pain. Typically this disease is found in sexually active women but sexually inexperienced, virginal girls have rarely been found with this infection.
Tubo-ovarian abscesses (TOA) are one of the late complications of pelvic inflammatory disease (PID) and can be life-threatening if the abscess ruptures and results in sepsis. It consists of an encapsulated or confined 'pocket of pus' with defined boundaries that forms during an infection of a fallopian tube and ovary. These abscesses are found most commonly in reproductive age women and typically result from upper genital tract infection. It is an inflammatory mass involving the fallopian tube, ovary and, occasionally, other adjacent pelvic organs. A TOA can also develop as a complication of a hysterectomy.
Patients typically present with fever, elevated white blood cell count, lower abdominal-pelvic pain, and/or vaginal discharge. Fever and leukocytosis may be absent. TOAs are often polymicrobial with a high percentage of anaerobic bacteria. The cost of treatment is approximately $2,000 per patient, which equals about $1.5 billion annually. Though rare, TOA can occur without a preceding episode of PID or sexual activity.
Symptoms in PID range from none to severe. If there are symptoms, then fever, cervical motion tenderness, lower abdominal pain, new or different discharge, painful intercourse, uterine tenderness, adnexal tenderness, or irregular menstruation may be noted.
Other complications include endometritis, salpingitis, tubo-ovarian abscess, pelvic peritonitis, periappendicitis, and perihepatitis.
Pelvic inflammatory disease or pelvic inflammatory disorder (PID) is an infection of the upper part of the female reproductive system namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis. Often there may be no symptoms. Signs and symptoms, when present may include lower abdominal pain, vaginal discharge, fever, burning with urination, pain with sex, or irregular menstruation. Untreated PID can result in long term complications including infertility, ectopic pregnancy, chronic pelvic pain, and cancer.
The disease is caused by bacteria that spread from the vagina and cervix. Infections by "Neisseria gonorrhoeae" or "Chlamydia trachomatis" are present in 75 to 90 percent of cases. Often multiple different bacteria are involved. Without treatment about 10 percent of those with a chlamydial infection and 40 percent of those with a gonorrhea infection will develop PID. Risk factors are similar to those of sexually transmitted infections generally and include a high number of sexual partners and drug use. Vaginal douching may also increase the risk. The diagnosis is typically based on the presenting signs and symptoms. It is recommended that the disease be considered in all women of childbearing age who have lower abdominal pain. A definitive diagnosis of PID is made by finding pus involving the fallopian tubes during surgery. Ultrasound may also be useful in diagnosis.
Efforts to prevent the disease include not having sex or having few sexual partners and using condoms. Screening women at risk for chlamydial infection followed by treatment decreases the risk of PID. If the diagnosis is suspected, treatment is typically advised. Treating a woman's sexual partners should also occur. In those with mild or moderate symptoms a single injection of the antibiotic ceftriaxone along with two weeks of doxycycline and possibly metronidazole by mouth is recommended. For those who do not improve after three days or who have severe disease intravenous antibiotics should be used.
Globally about 106 million cases of chlamydia and 106 million cases of gonorrhea occurred in 2008. The number of cases of PID however, is not clear. It is estimated to affect about 1.5 percent of young women yearly. In the United States PID is estimated to affect about one million people yearly. A type of intrauterine device (IUD) known as the Dalkon shield led to increased rates of PID in the 1970s. Current IUDs are not associated with this problem after the first month.
However, the infection arises insidiously, being potentially asymptomatic for a long period of time.
The infection may affect the kidneys, ureter and bladder and may cause significant damage to each.
Infertility is the major symptom of TFI and is generally defined as a woman under 35 who has not become pregnant after 12 months without the use of contraception. Twelve months is the lower reference limit for "Time to Pregnancy" (TTP) by the World Health Organization. When the inability to conceive is accompanied by signs and symptoms of pelvic inflammatory disease such as lower abdominal pain, TFI may be present. A history of pelvic inflammatory disease, the laproscopic evidence of scarring and a diagnosis of salpingitis supports the diagnosis.
Symptoms can vary. Some patients have lower often recurring abdominal pain or pelvic pain, while others may be asymptomatic. As tubal function is impeded, infertility is a common symptom. Patients who are not trying to get pregnant and have no pain, may go undetected.
Endometriosis, ruptured appendicitis, and abdominal surgery sometimes are associated with the problem. As a reaction to injury, the body rushes inflammatory cells into the area, and inflammation and later healing result in loss of the fimbria and closure of the tube. These infections usually affect both fallopian tubes, and although a hydrosalpinx can be one-sided, the other tube on the opposite side is often abnormal. By the time it is detected, the tubal fluid usually is sterile, and does not contain an active infection. (Not symptoms)
Tubal factor infertility can be due to Chlamydia infection and testing for Chlamydia antibodies is one diagnostic tool. Women have difficulty getting pregnant or carrying a baby to term due to the buildup of scar tissue in the Fallopian tubes causing damage to the cilia on the epithelial cells. TFI can also be due to endometriosis.
A hydrosalpinx is a distally blocked fallopian tube filled with serous or clear fluid. The blocked tube may become substantially distended giving the tube a characteristic sausage-like or retort-like shape. The condition is often bilateral and the affected tubes may reach several centimeters in diameter. The blocked tubes cause infertility.
A fallopian tube filled with blood is a hematosalpinx, and with pus a pyosalpinx.
Hydrosalpinx is a composite of the Greek words ὕδωρ (hydōr – "water") and σάλπιγξ (sálpinx – "trumpet"); its plural is "hydrosalpinges".
A hematosalpinx from a tubal pregnancy may be associated with pelvic pain and uterine bleeding. A gynecologic ultrasound will show the hematosalpinx. A hematosalpinx from other conditions may be painless but could lead to uterine bleeding.
A number of causes may account for a hematosalpinx, by far the most common being a tubal pregnancy. Blood may also escape into the peritoneal cavity leading to a hemoperitoneum.
A hematosalpinx can also be associated with endometriosis or tubal carcinoma. Further, if menstrual blood flow is obstructed (cryptomenorrhea), caused for instance by a transverse vaginal septum, and gets backed up it may lead to a hematosalpinx.
Oophoritis is an inflammation of the ovaries.
It is often seen in combination with salpingitis (inflammation of the fallopian tubes). It may develop in response to infection.
SIN is associated with infertility and ectopic pregnancy, and may present as either.
Fallopian tube obstruction is a major cause of female infertility. Blocked fallopian tubes are unable to let the ovum and the sperm converge, thus making fertilization impossible. Fallopian Tubes are also known as oviducts, uterine tubes, and salpinges (singular salpinx).
The significance of endosalpingiosis is not settled; medical experts differ on whether the condition itself causes issues or whether it is an asymptomatic finding. Common symptoms include, pelvic pain, infertility, menstrual irregularities and dyspareunia. Further reports suggest chronic back pain as a common issue reported years before diagnosis. Experts are unclear as the condition itself is a rare finding and lack of knowledge presents itself as a challenge.
Like the uterine endometrium of Endometriosis, estrogen can cause salpingoitic tissues outside of the fallopian tubes to grow and potentially aggravate the surrounding areas. High levels cause the glandular tissues to proliferate and, especially important, they cause the number of and activity of ciliated epithelial cells (that would normally line the fallopian tubes) to increase.
Salpingitis isthmica nodosa, also known as diverticulosis of the Fallopian tube, is nodular thickening of the narrow part of the uterine tube, due to inflammation. It is abbreviated SIN.
In gynecology, endosalpingiosis is a condition in which fallopian tube-like epithelium is found outside the fallopian tube. It is unknown what causes this condition. It is generally accepted that the condition develops from transformation of coelomic tissue. It is often an incidental finding and is not usually associated with any pathology.
Miliary tuberculosis is a form of tuberculosis that is characterized by a wide dissemination into the human body and by the tiny size of the lesions (1–5 mm). Its name comes from a distinctive pattern seen on a chest radiograph of many tiny spots distributed throughout the lung fields with the appearance similar to millet seeds—thus the term "miliary" tuberculosis. Miliary TB may infect any number of organs, including the lungs, liver, and spleen. Miliary tuberculosis is present in about 2% of all reported cases of tuberculosis and accounts for up to 20% of all extra-pulmonary tuberculosis cases.
Patients with miliary tuberculosis often experience non-specific signs, such as coughing and enlarged lymph nodes. Miliary tuberculosis can also present with enlarged liver (40% of cases), enlarged spleen (15%), inflammation of the pancreas (<5%), and multiple organ dysfunction with adrenal insufficiency (adrenal glands do not produce enough steroid hormones to regulate organ function). Miliary tuberculosis may also present with unilateral or bilateral pneumothorax rarely. Stool may also be diarrheal in nature and appearance.
Other symptoms include fever, hypercalcemia, chorodial tubercles and cutaneous lesions.
Firstly, many patients can experience a fever lasting several weeks with daily spikes in morning temperatures.
Secondly, hypercalcemia prevails in 16 to 51% of tuberculosis cases. It is thought that hypercalcemia occurs as a response to increased macrophage activity in the body. Such that, 1,25 dihydroxycholecalciferol (also referred to as calcitriol) improves the ability of macrophages to kill bacteria; however, higher levels of calcitriol lead to higher calcium levels, and thus hypercalcemia in some cases. Thus, hypercalcemia proves to be an important symptom of miliary tuberculosis.
Thirdly, chorodial tubercules, pale lesions on the optic nerve, typically indicate miliary tuberculosis in children. These lesions may occur in one eye or both; the number of lesions varies between patients. Chorodial tubercules may serve as important symptoms of miliary tuberculosis, since their presence can often confirm suspected diagnosis.
Lastly, between 10 and 30% of adults, and 20–40% of children with miliary tuberculosis have tuberculosis meningitis. This relationship results from myobacteria from miliary tuberculosis spreading to the brain and the subarachnoid space; as a result, leading to tuberculosis meningitis.
The risk factors for contracting miliary tuberculosis are being in direct contact with a person who has it, living in unsanitary conditions, and having an unhealthy diet. In the U.S., risk factors for contracting the disease include homelessness and HIV/AIDS.
Tuberculosis may infect any part of the body, but most commonly occurs in the lungs (known as pulmonary tuberculosis). Extrapulmonary TB occurs when tuberculosis develops outside of the lungs, although extrapulmonary TB may coexist with pulmonary TB.
General signs and symptoms include fever, chills, night sweats, loss of appetite, weight loss, and fatigue. Significant nail clubbing may also occur.
Approximately 20% of female infertility can be attributed to tubal causes. Distal tubal occlusion (affecting the end towards the ovary) is typically associated with hydrosalpinx formation and often caused by "Chlamydia trachomatis". Pelvic adhesions may be associated with such an infection. In less severe forms, the fimbriae may be aggluntinated and damaged, but some patency may still be preserved. Midsegment tubal obstruction can be due to tubal ligation procedures as that part of the tube is a common target of sterilization interventions. Proximal tubal occlusion can occur after infection such as a septic abortion. Also, some tubal sterilization procedures such as the Essure procedure target the part of the tube that is near the uterus..
If a tuberculosis infection does become active, it most commonly involves the lungs (in about 90% of cases). Symptoms may include chest pain and a prolonged cough producing sputum. About 25% of people may not have any symptoms (i.e. they remain "asymptomatic"). Occasionally, people may cough up blood in small amounts, and in very rare cases, the infection may erode into the pulmonary artery or a Rasmussen's aneurysm, resulting in massive bleeding. Tuberculosis may become a chronic illness and cause extensive scarring in the upper lobes of the lungs. The upper lung lobes are more frequently affected by tuberculosis than the lower ones. The reason for this difference is not clear. It may be due to either better air flow, or poor lymph drainage within the upper lungs.