Pathogenesis of pelvic inflammatory disease.

Our current concept of the pathogenesis of pelvic inflammatory disease (PID) is a synthe- sis of information from many sources.The main part is indirectly derived from epidemiological, clinical, and laboratory observations, as well as from deductions by analogy from findings in experimental systems.Docu- mented facts are scarce, fragmentary, and in part contradictory.PID is defined as "the acute clinical syndrome associated with ascending spread of microorganisms (unrelated to pregnancy or surgery) from the vagina or cervix to the endometrium, fallopian tubes, and/or con- tiguous structures".'The definition is wide and includes a multitude of inflammatory conditions of the female pelvic organs.This review will focus upon infection of the prog- nostically most important anatomical struc- ture-the Fallopian tube; that is, on acute salpingitis.Aetiological microorganisms in acute salpingitis Bacterial species isolated from the Fallopian tubes in cases of salpingitis fall into two main categories; sexually transmitted (disease; STD) organisms, and species indigenous to the lower genital tract (endogenous organ- isms).