Case Of Salpingitis Research Articles

First report of Gallibacterium isolation from layer chickens in Iran

Gallibacterium, a gram-negative coccobacillus, is a genus of the Pasteurellaceae family with capability of infecting a wide range of avian host species. In 2003, Gallibacterium was selected instead of different previous names. Four different species has been recognized in Gallibacterium genus so far. Members of the genus can cause a wide range of pathological lesions, from upper respiratory tract lesions, follicle degeneration, enteritis, pericarditis, hepatitis, oophoritis, septicemia to more important problems such as salpingitis and peritonitis. Salpingitis and peritonitis of layer farms caused by Gallibacterium result in decreased egg-production and increased mortality. Gallibacterium is the most common single bacterial infection in egg-laying farms with reproductive disorders. During a microbiological survey on bacterial infectious agents of reproductive tract of layers, some isolates from salpingitis cases were suspicious of Gallibacterium. According to culture and biochemical properties, the primary identification was in support of genus Gallibacterium. A polymerase chain reaction (PCR) test using primers specific for the genus identification was carried out. The suspected isolate showed bands of 970 and 1080 bp, which are specific for Gallibcterium. To confirm the identification, a positive sample was sent to University of Copenhagen for repeating the PCR test. To our knowledge, this is the first report of isolation and identification of Gallibacterium in Iran. This study shows the possibility of a role for Gallibacterium in poultry industry of Iran. This study also shows the need for further investigations on epidemiological situation of the infection, as well as the isolation and identification of different species of the genus Gallibacterium.

English

The spectrum of lesions encountered in the fallopian tube, their age wise incidence and histopathology are studied. Eight hundred and forty cases where fallopian tubes were removed either separately as salpingectomy specimens or along with hysterectomy or as salpingo-ophorectomy specimens were analysed and their histopathological findings were documented. Majority of tubal specimens were normal. There is significant number of chronic nonspecific salpingitis cases. The rare cases in our study are actinomycosis and primary adenocaricnoma.

INVOLUÇÃO UTERINA, ATIVIDADE OVARIANA, PRIMEIRO CIO PÓS-PARTO E DISTÚRBIOS REPRODUTIVOS EM BÚFALAS

The aim of the present study was to evaluate some reproductive characteristics such as uterine involution, ovarian activity and first estrus after parturition, and reproductive disorders in buffaloes reared in the mixed system (floodplain and land / artificial pasture) in an experimental farm of Belém, Pará State, Brazil. A total of 62 female buffaloes and 167 postpartum periods were evaluated between 2002 to 2005 through gynecological and ultrasound examination. Animals were kept on artificial pasture during the rainy season (January-June) whereas on the floodplain areas with excellent availability of pasture during the dry season (July-December). The resumption of ovarian activity, verified by visual observation of the first estrus, was in average 47.06 ± 25.66 days, while the uterine involution verified by rectal palpation and ultrasound examination was 27.5 ± 7.77 days. The number of cases of abortion, retained placenta and embryonic death were 10 (5.90%), 13 (7.78%) and 14 (8.38%) cases, respectively, while the number of cases of uterine infection was 18 (10.7%). Regarding nonfunctional ovaries, 26 (15.56%) cases were found and two (1.19%) cases of ovarian hypoplasia, three (1.79%) cases of ovarian cysts and two (1.19%) cases of salpingitis were observed.KEYWORDS: Buffaloes, postpartum ovarian activity, reproductive disturbances, reproductive efficiency.

Characterization of Escherichia coli Isolates from Commercial Layer Hens with Salpingitis

Problem statement: Escherichia coli isolates are the most common bacterial agents of salpingitis in commercial layer hens. The objectives of this study were to determine the phylogenetic groups/subgroups and antibiotic resistance of E. coli isolates from salpingitis cases in commercial layer hens farms in southeast of Iran. Approach: One hundred twenty one E. coli isolates from oviducts of layer hens with salpingitis were examined to determine their O-serogroup, phylogenetic group/subgroup and antibiotic resistance pattern. Results: O-serogroup determination test showed that 47 (38.84%) isolates were typeable and belonged to eleven different O serogroups including: O1, O2, O6, O8, O15, O20, O25, O36, O78, O86 and O111 and 71 (58.67%) isolates were O-nontypeable. Three most prevalent serogroup were O78, O2 and O1 respectively. PCR assays showed that the isolates fall into four phylogenetic groups A (41.32%), D (33.88%), B2 (14.87%) and B1 (9.91%). Ninety nine (81.81%) isolates fell into six phylogenetic subgroups including: A0 (17.35%), A1 (23.96%), B22 (5.78%), B23 (9.09%), D1 (13.22%) and D2 (20.66%). All of the E. coli isolates from O78 serogroup belonged to A phylo-group whereas the O2 isolates mostly fell into D group. The maximum antibiotic resistance was against tetracycline (100%) and minimum resistance was against linco-spectin (37.19%). Twenty four isolates (19.83%) were resistant to all of the examined antibiotics. Twenty three different patterns of multiple drug resistance were observed, out of which N-Te-Sxt-Fm- Nfx-C and N-Te-Sxt-Gm-Fm-Nfx-C-Ls was the two most frequent patterns respectively. The resistant isolates were found in all of the phylogenetic groups and or sub groups. Conclusion: There are similarities between salpingitis derived E. coli strains and other avian pathogenic E. coli isolates in phylogroups, O-serogroups and antibio-resistance patterns.

Reduction in hospitalized women with pelvic inflammatory disease in Oslo over the past decade

A tuboovarian abscess (TOA) is a common complication of pelvic inflammatory disease (PID), occurring world-wide in 15-30% of women with PID. The aim of the study was to identify changes during the last 10 years in the number of women hospitalized with PID in Oslo, as well as a change regarding the frequencies of the subdiagnoses salpingitis and tuboovarian abscess. We performed a review of computerized diagnosis lists and manual check of the medical records of women hospitalized with PID in Oslo. The years 1990-92 and 2000-02 were included, resulting in information from two time periods 10 years apart. Cases were registered as salpingitis, oophoritis or tuboovarian abscess. Medical and demographic variables from the medical records of women diagnosed during 4 out of the 6 years were described in detail. We identified 523 women with the diagnosis of PID hospitalized during 1990-92 and 2000-02. There was a 35% reduction in hospitalized cases of salpingitis over the period of 10 years, but the number of cases of tuboovarian abscesses among women admitted for PID remained unchanged from 1990-92 to 2000-02. We found low frequencies of Chlamydia trachomatis and Neisseria gonorrhoea infections, although documented bacteriological sampling was insufficient. Fewer patients were hospitalized in Oslo for PID during the time period of 2000-02 compared with 10 years earlier, but a higher percentage of patients had developed TOA compared with the first time period (43% compared with 26%, p = 0.013), indicating a changing clinical panorama of PID.

Detection of chlamydia trachomatis DNA in archival paraffinized specimens from chronic salpingitis cases using the polymerase chain reaction

Objective: To identify Chlamydia trachomatis by the polymerase chain reaction (PCR) in fallopian tube tissues with chronic salpingitis. Design: Retrospective case-control study. Setting: Academic tertiary institution. Patient(s): Women with a pathological diagnosis of chronic salpingitis or normal fallopian tube hospitalized between September 1992 and November 1994. Initial identification of 248 specimens with final analysis of 154. Intervention(s): Paraffin-embedded fallopian tube tissues were analyzed with use of PCR to detect C. trachomatis. Main Outcome Measure(s): Identification of C. trachomatis DNA; demographics of age, ethnicity, parity, history of sexually transmitted disease, and surgical procedure. Result(s): C. trachomatis DNA was detected in 9 of 77 chronic salpingitis cases. Seventy-seven controls were negative for C. trachomatis. No statistically significant difference in age or ethnicity between cases and controls was identified. Nulliparity was more frequent in cases (26 of 74) than controls (14 of 76). Sexually transmitted disease history was more prevalent in cases (24 of 74) than controls (6 of 76). Chlamydia infection was not associated with a particular surgical indication. Conclusion(s): Chronic salpingitis is highly associated with the presence of C. trachomatis infection as detected by PCR.

The frequency of salpingitis and ectopic pregnancy as epidemiologic markers of Chlamydia trachomatis.

To study the incidence of non-gonococcal salpingitis, gonococcal salpingitis and ectopic pregnancy in a defined population over a 28-year period on the assumption that the frequency of salpingitis and ectopic pregnancy may indirectly illustrate the epidemiological pattern of Chlamydia trachomatis. A retrospective epidemiological study. University hospital with an urban catchment area. Five thousand two hundred and thirty-three patients admitted to the hospital between 1969 and 1996 with a diagnosis of ectopic pregnancy, non-gonococcal salpingitis, or gonococcal salpingitis. The frequencies of both non-gonococcal and gonococcal salpingitis increased steeply early in the period under study, rising to a peak in the early 1970s, then decreasing throughout the period except for the last 3 years when a slight increase was seen again. The frequency of ectopic pregnancy showed a steady increase, peaking in the late 1980s and early 1990s and then declining at the end of the study period. While the introduction of more sensitive pregnancy tests and programs for assisted fertility would increase the rate of ectopic frequency the decline during the 'nineties cannot be accounted for in this way. The peak of salpingitis cases in the early 'seventies seems to be mirrored exactly by the peak of ectopic pregnancies fifteen years later in the late 'eighties. The frequencies of salpingitis and of ectopic pregnancy can probably be used to estimate the incidence of preceding Chlamydia trachomatis. Thus the incidence of C. trachomatis has probably declined since the early 'seventies like that of N. gonorrheae.

Pelvic inflammatory disease after tubal sterilization: a review.

Exceptions ot the common notion that tubal occlusion protects from recurrent pelvic inflammatory disease (PID) do exist. Since 1975, 71 cases of salpingitis and 38 tubo-ovarian abscesses (TOA) in sterilized women have been published. The majority of cases of salpingitis after previous tubal occlusion (SPOT) developed more than a year after either laparoscopic or laparotomy sterilization procedures. For tubo-ovarian abscess after previous tubal occlusion (TOAPOT), this time interval ranged from several weeks to almost two decades. Most cases of salpingitis showed inflammation of both tubal segments. When only one segment was involved, it was generally the proximal segment. The appearance of the TOAPOT at the time of surgery was typical to TOA. The symptoms of salpingitis were not different from symptoms in any other case of PID, and those associated with TOAPOT were typical of TOA. Laboratory findings included leucocytosis and growth of Neisseria gonorrohoea and Chlamydia trachomatis from the cervix, the infected tube, and the peritoneal fluid. Pus cultures obtained from cases of TOAPOT grew mixed or single organisms. Detailed histopathologic studies in tubal specimens after the failure of an occlusion procedure are available from cases with no infection. They have demonstrated distortion, loss of musculature, and loss of lumen configuration, all of which may have been the result of compromised blood supply to the tube. These findings may be extrapolated to cases of SPOT and TOAPOT, assuming similar changes may be present before the development of infection. The mechanisms by which infection may develop in previously occluded tubes are divided into three groups: The first group consists of situations where there is persistence of free passage between the proximal and distal portions of the tube. These include toboperitoneal fistula, spontaneous anastomosis at the occlusion site, recanalization of the occluded site, incomplete tubal occlusion due to a faulty surgical technique or rupture of the weakened tubal wall. The second group consists of infections initiated by the surgical procedure itself, such as introduction of pathogens at surgery, exacerbation of chronic PID, and ascending infection secondary to surgical manipulation. In the third group, the infection is initiated systemically by hematogeneous spread, lymphatic spread, or change in immunologic status.

Natural case of salpingitis apparently caused by Mycoplasma gallisepticum in chickens

Summary A natural case of salpingitis, apparently caused by Mycoplasma gallisepticum (MG), in layer chickens is described. In the flock from which the chickens originated, there was a 3 to 4% drop in egg production per month around 250 days old. The production was reduced 70% at 400 days of age, which was 77% of the predisease level. Salpingitis was characterized by marked thickening of the oviductal mucosa due to epithelial hyperplasia and marked lymphoplasmacytic infiltration. Colonization of MG on the epithelial surface was evidenced by electron microscopy and immunohistochemistry using rabbit hyperimmune serum against the S6 strain of MG. Antibodies to MG were detected in all the chickens examined..

Salpingitis in web‐footed birds: Prevalence, aetiology and significance

Among 4,893,447 ducks slaughtered during a 10 year period in a single slaughterhouse in Denmark 7,190 (0.15%) were condemned because of salpingitis. A further 21,658 ducks (0.44%) were approved for human consumption after the inflamed salpinx had been removed. Annual condemnation due to salpingitis varied from 0 to 0.53% and total condemnation varied from 1.30 to 2.72%, with an average of 1.98%. Sixteen different bacterial species were isolated in pure culture from salpingitis in 7 week-old ducks. Infections caused by Riemerella anatipestifer (66.5%) and Escherichia coli (14.6%) dominated. E. coli (37.5%), taxon 3 (18.8%), Pasteurella multocida ssp. multocida (12.5%), and taxon 2 (9.4%) were most frequently isolated from salpingitis in egg-laying ducks. E. coli (23.1%), taxon 2 (23.1%), and P. multocida ssp. multocida (20.5%) dominated in geese. At least seven different serovars of R. anatipestifer were demonstrated, and among 106 E. coli strains serotyped, at least 30 0-groups were demonstrated. Egg production observed in a flock of parents suffering from a serious outbreak of R. anatipestifer infection at the age of five weeks indicates that the infection might have a negative influence on subsequent reproduction. The isolation of bacterial species which are often present on the cloacal mucous membranes of normal web-footed birds, in addition to the isolation of a large number of 0-groups of E. coli from cases of salpingitis in such birds, supports the idea that ascending infections may account for some of the cases seen.

Epidemiology of urogenital infections caused by Chlamydia trachomatis and outline of characteristic features of patients at risk.

A study of Chlamydia trachomatis infection was conducted in two stages on 15,656 subjects at urogenital clinics of the Faculty of Medicine and Surgery at La Sapienza University in Rome, the S. Anna Hospital in Turin, and the Niguarda Hospital in Milan. The overall incidence of the disease was 6.4% in patients examined throughout the whole study period. The rate of positive cases was 5.8% for the 5270 patients examined up to 1990, and 6.7% for the 10,386 patients examined from 1990 to 1992, showing an increasing trend. There was a much higher positivity rate in men (9.8%) than in women (6.0%); the difference was statistically significant. Of all patients, 60%, were asymptomatic. In symptomatic patients, C. trachomatis was present in 18.5% of cases of non-gonococcal urethritis and in 12.8% of cases of salpingitis. The highest incidence of C. trachomatis infection was in women who had begun sexual activity at an early age, (under 25 years in age), had several sexual partners and used intra-uterine contraceptive devices or spermicides or both.

Salpingitis or oophoritis: What causes fever following oocyte aspiration and embryo transfer?

Febrile morbidity following in vitro fertilization and embryo transfer (IVF-ET) is a rare but possibly serious complication. This report describes a case of salpingitis after IVF-ET and discusses the possible reasons for febrile morbidity following this common procedure.A 37-year-old woman undergoing IVF-ET for tubal factor infertility developed sudden, severe pelvic pain, fever, and leukocytosis 24 hours after ET. Laparoscopy revealed bilateral suppurative pyosalpinges with cystic, hemorrhagic ovaries. Pain, fever, and leukocytosis resolved with conservative surgery and intravenous antibiotic therapy.This case presents laparoscopic documentation of a rare complication of oocyte aspiration and/or ET, namely, salpingitis. Possibilities for the development of salpingitis following IVF-ET include activation of quiescent bacteria within the fallopian tubes from a previous pelvic infection, puncture of the bowel during oocyte aspiration, inoculation of the pelvis with cervicovaginal flora during oocyte aspiration, and introduction of bacteria-laden secretions or air into the fallopian tubes during ET. Although rare, the possibility of severe pelvic infection following IVF-ET warrants consideration of prophylactic antibiotic coverage.

Experience with Laparoscopic Appendectomy —The Technique and Our Views of its Indications—

Abstract: Since June, 1991 a laparoscopic appendectomy (LA) was performed on eleven patients with suspected appendicitis which could not be confirmed by the conventional diagnostic methods. The patients included 7 males and 4 females, with a mean age of 27, 9, ranging from 16 to 46 years. No postoperative complications were encountered. The laparoscopic diagnoses included gangrenous appendicitis in 2, suppurative appendicitis in 2, catarrhal appendicitis in 4, salpingitis in 2 and an appendiceal mass in one patient (Case 7). Histopathological diagnoses were phlegmonous appendicitis in 3, mucinous cystadenoma in one and catarrhal appendicitis in 7 patients. Two cases of salpingitis and a case with ovarian bleeding were treated conservatively after incidental laparoscopic removal of the appendix. Case 7 was histopathologically diagnosed as having mucinous cystadenoma. The patients’postoperative hospital stay was from 5 to 8 days, with an average of 6.9 days. All patients had been given the permission to be discharged by the third POD but they stayed longer because of benefits given by the health insurance system very specific to Japan.LA in our clinic has so far been limited to selected patients in whom the diagnosis of appendicitis could not been confirmed and laparoscopic examination was indicated, mainly due to manpower problems involving surgeons, anesthetists and operating room nurses. However, LA provides not only benefits for patients but also several merits for surgeons including better exposure of the operating field in most cases when compared with an open appendectomy. We feel, therefore, that the indications for LA might be extended more widely, probably to most cases of appendicitis.

Serovars ofChlamydia trachomatis causing postabortion salpingitis

In a previously reported investigation, 69 women with genital chlamydial infection following legal abortion were studied prospectively. Ten cases of postabortion salpingitis and 16 cases of endometritis were identified. To ascertain whether some serovars of Chlamydia trachomatis are particularly likely to initiate an infection in the fallopian tubes and cause salpingitis, the chlamydial isolates from the patients with salpingitis and those isolates from cases free of infectious complications were serotyped using a panel of monoclonal antibodies. Six of the seven different serovars demonstrated in the symptom-free group were identified in salpingitis cases. The strains associated with salpingitis seemed to reflect the overall distribution of chlamydial serovars in the entire study group. The predominant serovars were E, F and H. A protective effect associated with chlamydial serum antibodies had previously been observed in salpingitis cases. Therefore, the antibody titres subdivided according to serovar were compared. No difference in the antibody response induced by the different serovars could be verified statistically, but the B-complex strains were associated with a higher antibody titre than the C-complex strains or the intermediate strains F and G.

Pyosalpinx Subsequent to Tubal Ligation

A case of salpingitis with pyosalpinx subsequent to tubal ligation is described. The procedure was performed at the time of cesarean section 7 years earlier. The pyosalpinx included the distal portion of the ligated tube, with no evidence of infection in the proximal segment. Although pelvic peritonitis, salpingitis and tubo-ovarian abscess are rare following tubal ligation, they should be suspected in any patient presenting with lower abdominal pain.

Risk Factors for Ectopic Pregnancy

To the Editor.— The article entitled Ectopic Pregnancy and Reproductive Technology 1 in the March 25 issue ofTHE JOURNALindicates a decline in the proportion of cases of salpingitis caused by Neisseria gonorrhea , citing a current culture rate of less than 30% of women with pelvic inflammatory disease. These figures seem low in light of the 54% culture rate reported in recent articles. 2 I agree with the conclusion that chlamydia has emerged as an increasingly prevalent cause of tubal pregnancy. Anatomic changes with Chlamydia trachomatis infection include hypertrophy and engorgement of the vaginal walls and an increase in glycogen content of the vaginal epithelium. These changes may predispose to secondary infection with Escherichia coli or Bacterioides fragilis . 2 Ascending infection can lead to scarring of the fallopian tubes and an increase in ectopic pregnancy rates. I agree with the authors that chlamydiae are unlikely to be eradicated unless

Salpingitis; Aspects of Diagnosis and Etiology

Salpingitis; Aspects of Diagnosis and Etiology

Epidemiology of sexually transmitted Chlamydia trachomatis infections.

This paper provides a comprehensive review of the literature on the epidemiology of sexually transmitted chlamydial infections. Its major sections focus on the following substantive areas: microbiology, serologic classification, infections of men (urethritis, epididymitis, prostatitis), infections of women (endocervicitis, urethritis, salpingitis, endometritis, infertility, ectopic pregnancy), effect of genital chlamydial infections on pregnancy, other diseases (Reiter's syndrome, cervical atypia, gastrointestinal infection, lymphogranuloma venereum), and prevention and control programs. It is conceded that wide gaps remain in our understanding of the epidemiology of these organisms. If the estimate that 20% of salpingitis cases are due to C trachomatis is accepted, then at least 20,000 women/year in the US may be infertile because of chlamydial infection. At present, there is a need to define the prevalence and incidence of chlamydial infection in different populations so that high risk groups can be identified and targeted for prevention programs. Studies must also continue to test the link between maternal chlamydial infection and abortion, prematurity, perinatal mortality, and puerperal maternal infections. Ultimately, the most efficient approach to managing chlamydial infection may be provided by a vaccine.

Antibodies to Chlamydia trachomatis, Mycoplasma hominis, and Neisseria gonorrhoeae in Sera from Patients with Acute Salpingitis

Although there are diverse opinions on the proportion of acute salpingitis caused by Neisseria gonorrhoeae, most workers agree that other agents can be responsible for this condition. The authors have shown previously that Chlamydia trachomatis and Mycoplasma homonis are agents that may cause nongonococcal pelvic inflammatory disease. In the present study, they tested paired sera from 60 consecutive patients with acute salpingitis for antibodies to C. trachomatis by an indirect immuno-fluorescence test, and for antibodies to M. hominis and N. gonorrhoeae by indirect hemagglutination tests. Sera from 50 pregnant women attending consecutively from the same hospital catchment area served as controls. Antibodies (lgG or lgM or both) to C. trachomatis were detected in 80 per cent of the patients, and antibodies to M. homonis and N. gonorrhoeae were found in 40 per cent and 18 per cent, respectively. lgM antibodies to C. trachomatis occurred in 12, and lgG antibodies to the same organism occurred in all 48 seropositive patients. A significant change in antibody titre to C. trachomatis occurred in 40 per cent of the patients (21 with lgG, one with lgM, and two with both antibodies), to M. homonis in 12 per cent, and to N. gonorrhoeae in 5 per cent. The predictive values for a positive and a negative microimmunofluorescence test result were 44 per cent and 83 per cent, respectively; those for the indirect hemagglutination gonococcal pilar antibody test were 36 and 100 per cent, respectively. These calculations were based on the assumption that the diagnosis of a current infection was equivalent to a positive culture result for the organism. None of the 12 patients with lgM antibodies to C. trachomatis was culture positive for chlamydia. Evidence of a current infection (culture positive or significant change of antibody titer or both) with C. trachomatis and N. gonorrhoeae occurred in 35 (58 per cent) and five (8 per cent), respectively. Of the 23 patients with positive cultures for chiamydia, 17, 5, and 1 had titres of less than 64, from 128 to 156, and greater than 512, respectively. Ten had a significant rise in the titre of antichla-mydial lgG antibodies. The four patients who harbored gonococci were in the group of 11 patients who had indirect hemagglutination pilar antibodies to N. gonorrhoeae. Two of the three patients with a significant rise in titre harbored gonococci. There was a correlation between the severity of the tubal changes and the results of the microimmunofluorescence tests (P < 0.005) and between the duration of pelvic pain before attendance and the results of serological tests (P < 0.009). Four (7 per cent) of the 60 patients had a significant rise in antibody titres to both C. trachomatis and M. hominis. The three patients with a significant rise in the titre of indirect hemagglutination pilar antibodies had no evidence of current infection with chlamydia or mycoplasmas. Antibodies to C. trachomatis, M. hominis, and N. gonorrhoeae were demonstrated in 8, 8, and 6 per cent, respectively, of the sera from the control group of pregnant women. The study showed that acute salpingitis in Lund is associated with a current genital chlamydial infection in at least 40 per cent of the patients, whereas gonococcal infections at present occur in only a small proportion of all cases of salpingitis (8 per cent). Acute infections with M. hominis could be detected in 10 to 15 per cent of the patients with acute salpingitis in the area.

Antibodies to Chlamydia trachomatis, Mycoplasma hominis, and Neisseria gonorrhoeae in sera from patients with acute salpingitis.

Paired sera from 60 consecutive patients with acute salpingitis, confirmed by laparoscopy, were examined for serum antibodies to Chlamydia trachomatis, Mycoplasma hominis, and Neisseria gonorrhoeae. By a microimmunofluorescence (MIF) test IgM or IgG antibodies to C trachomatis or both were present in sera from 80% of the patients' by indirect haemagglutination (IHA) tests antibodies to M hominis and N gonorrhoeae pilar antigens were present in 40% and 18% respectively. In a control group of 50 pregnant women antibodies to the same three organisms occurred in 8%, 8%, and 6%. Evidence of current chlamydial infection was found in 35 (58%) and of current gonococcal infection in five (8%) of the 60 patients by culture or serological tests or both. The results of chlamydial antibody tests correlated with the severity of the tubal inflammation (as shown by laparoscopy) and the duration of the lower abdominal pain before attendance. The predictive values of a positive and a negative MIF test result were 44% and 83% respectively and of the IHA gonococcal antibody test 36% and 100% respectively. Significant rises in titre of antibodies to M hominis were found in 12% of patients. A four-fold or greater rise in titre indicated probable double infections with chlamydia and mycoplasmas in 7% of patients. Thus, at present gonococcal salpingitis appears to form only a small proportion of all cases of salpingitis in southern Sweden, and in patients with nongonococcal salpingitis infections with C trachomatis and M hominis commonly occur.