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.