Acute salpingitis and thiamphenicol: a microbiologic and therapeutic study

Eighty-five sexually active women with clinically suspected adnexitis and illness severe enough to require hospitalization were studied. The clinical diagnosis, based on anamnestic data and physical and pelvic examination, was confirmed by laparoscopy and by cultures for aerobic and anaerobic bacteria and for Chlamydia in both cervical canal and intraperitoneal secretions. A ten-day course of thiamphenicol was begun on an empirical basis after laparoscopy. The results showed that fever, an elevated erythrocyte sedimentation rate, and leukocytosis are unreliable diagnostic parameters and that laparoscopy in conjunction with microbial cultures is the only method by which a definite etiologic diagnosis can be established. Positive results of cultures of specimens from the cervical canal are sufficient for the diagnosis of infection due to Neisseria gonorrhoeae, whereas positive culture results for specimens from the intraperitoneal cavity are necessary for the diagnosis of infection caused by Chlamydia trachomatis. Primary treatment with thiamphenicol was successful in 77 (91%) of the 85 patients. Thus, thiamphenicol proved to be effective in the treatment of acute adnexitis.