Acute Salpingitis Flashcards
Tubo-ovarian abscess? Treatment?
Collection of purulent material around distal tube and ovary;
unlike typical abscess, can be treated with antibiotic therapy
Salpingitis – a.k.a.? Suggestive physical exam sign?
Pelvic inflammatory disease; Cervical motion tenderness
Common presentation of salpingitis?
Young, nulliparous female complaining of lower abdominal/pelvic pain and vaginal discharge with fever, and nausea/vomiting
Signs and symptoms of acute salpingitis?
- Abdominal, Cervical motion, adnexal tenderness
- Vaginal discharge
- Fever
- Pelvic mass on physical exam/ultrasound
Fitz-Hugh and Curtis syndrome?
Right upper quadrant pain seen in salpingitis when PERIHEPATIC ADHESIONS are present
When salpingitis diagnosis is in doubt – best confirmatory method? Look for?
Laparoscopy; purulent discharge from fimbria
Manage salpingitis as outpatient if? Tx?
- Low-grade fever
- Absence of paratonia signs
- Tolerance of oral medication
Single IM ceftriaxone and oral doxycycline for 10-14 days
Criteria for inpatient therapy?
- Fails outpatient therapy (after reassessing for you hours after initiating)
- Pregnant
- Extremes of age (no teenagers)
- Cannot tolerate oral medication ( nausea)
IV cefotetan or oral/IV doxycycline
Patient on inpatient therapy for salpingitis does not improve within 48 to 72 hours – next step?
Laparoscopy to assess disease
Tubo-ovarian abscess – organism? Abx? Complication?
Alternative treatment?
Anaerobics; clindamycin or metronidazole
Rupture
Radiological percutaneous drainage
Long-term complications of salpingitis?
- Chronic pelvic pain
- Involuntary infertility
- Ectopic pregnancy
Infertility from PID directly related to?
Number of episodes of salpingitis
Contraception that increases risk for PID? (Why?) another risk factor?
Decreases risk?
IUD (endocervical barrier is broken upon placement of IUD); OCP
Nulliparity
Acute salpingitis – organism?
Multiple organisms
Gold standard for diagnosing salpingitis?
Laparoscopy
