Acute salpingitis with Chlamydia trachomatis isolated from the fallopian tubes: clinical, cultural, and serologic...

Chlamydia trachomatis was recovered from the fallopian tubes of ten women with acute salpingitis. The median age of the patients was 19 years. The duration of pelvic pain before consulting a physician ranged from three to 27 days (median, seven days). Half of the patients complained of irregular bleeding, and nine reported increased vaginal discharge. One patient had a rectal temperature of greater than 38 C, and one had an erythrocyte sedimentation rate of less than 15 mm/hr. At laparoscopy, mild inflammatory changes were seen in the tubes of three patients, five had moderately severe inflammation, and two had pelvic peritonitis. C. trachomatis could not be isolated from the cervix of two patients. Paired sera were available from eight patients, six of whom had a significant rise in titer of IgG antibodies to C. trachomatis. Two women had IgM antibodies. Two other women, who harbored Neisseria gonorrhoeae in the cervix, had antibodies to gonococcal pili; one had a significant decrease in titer. This latter patient was one of the patients with a stationary titer of antibodies to C trachomatis. One patient had a stationary titer of antibodies to Mycoplasma hominis. In general, chlamydial salpingitis seems to have relatively benign symptoms. Neither the failure to isolate C. trachomatis from the cervix nor a stationary titer of antibodies to the organism precludes a chlamydial etiology of acute salpingitis.