Acute suppurative salpingitis with concomitant intrauterine pregnancy.
A 20-year-old woman presented to the emergency department with a history of lower abdominal pain and recent loss of consciousness. She was admitted with a primary diagnosis of abdominal pain; ectopic pregnancy was ruled out. The culture of the endocervix was positive for Neisseria gonorrhoeae. Surgical exploration of the pelvis was performed, and histological analysis of the specimen showed an acute suppurative salpingitis and an intrauterine pregnancy. The patient was placed on intravenous antibiotics. Postoperative course was unremarkable, and the patient was discharged on oral antibiotics. Although a rare entity acute suppurative salpingitis with concomitant intrauterine pregnancy are not mutually exclusive. Ectopic pregnancy should be the presumptive diagnosis when clinical presentation is consistent with pelvic inflammatory disease and pregnancy especially in the first trimester. Patients who are pregnant and exhibit clinical signs and symptoms that are consistent with salpingitis should be admitted for aggressive management of their high-risk pregnancy. Fetal wastage seems to be significant in spite of aggressive management. Endocervical culture for N gonorrhoeae should be obtained from all pregnant patients with follow-up treatment pending culture results. The following is a case presentation along with a review of the existing cases in the English literature and discussion of the possible pathogenesis and clinical outcome of this entity.
Yip
L
L
Department of Emergency Medicine, State University of New York, Syracuse 13210.
Sweeny
P J
PJ
Bock
B F
BF
D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006069:Gonorrhea / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D011256:Pregnancy Outcome; D012488:Salpingitis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013492:Suppuration; D002577:Uterine Cervical Diseases / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D014626:Vaginal Smears
D000900:Anti-Bacterial Agents