Acute salpingitis in the adolescent female

Acute salpingitis is an important complication of sexually transmitted disease in young women and should be considered in the differential diagnosis of abdominal pain in all young women. Many organisms, in addition to N. gonorrhoeae, have been associated with this tubal infection giving support to polymicrobial etiology. However, the exact pathophysiologic role of these organisms needs to be clearly defined. The microbiology of acute salpingitis, through direct culture from the site of infection, the fallopian tubes, needs to be clearly elucidated. Early recognition and treatment of acute salpingitis is essential in preventing the major long-term problem, involuntary infertility. Curran has estimated the reproductive outcome for a cohort of adolescent women reaching reproductive age in 1970. By the year 2000, there will have been one episode of salpingitis for every two women; 15% will be hospitalized for salpingitis with over half of these women requiring major gynecologic surgery; 10% will be rendered nonsurgically sterile; and 3% will have experienced an ectopic pregnancy. Adolescent females may be more susceptible to upper genital tract infection than older women due to possible unique biologic characteristics and sexual behaviors. Prospective microbiologically controlled studies of women with salpingitis using laparoscopy need to be developed to evaluate treatment regimens. Until such studies are undertaken, diagnosis, treatment, and fertility in women with acute salpingitis will remain unsatisfactory.