Laparoscopic and microbiological features of acute salpingitis in developing countries

One hundred and twenty-four out of 198 consecutive women who underwent diagnostic lasparoscopy for clinical symptoms and signs of acute salpingitis at the University College Hospital, Ibadan, Nigeria had acute salpingitis. These were slightly younger than those without acute salpingitis, otherwise there were no differences in the sociodemographic characteristics of the two groups. Urinary and gastrointestinal symptoms, abnormal vaginal discharge, fever (> 38 degrees C) and sexually transmitted organisms were significantly more in women with acute salpingitis. Ninety-five per cent of the Neisseria gonorrhoea cultured were of the PPNG strain. Pelvic adhesions were present in 69.4% of the women with acute salpingitis. Forty-one per cent of the women had tubal occlusion. It was concluded that laparoscopy rather than clinical findings alone would determine the severity of acute salpingitis. This should be performed along with culture of genital discharges and peritoneal fluid for optimum management. The use of a single dose broad spectrum antibiotics active against both PPNG and non-PPNG strains, and chlamydial infections is advocated for treatment in developing countries.