Abstract

(1) Thirteen women with verified acute gonococcal pelvic inflammatory disease were treated with penicillin, given in saline suspension intramuscularly every three hours in dosages of 20,000 to 25,000 units, with usual total doses of 400,000 units.(2) AH apparently were bacteriologically cured of gonorrhea, as shown by repeated smears and cultures. In one case (Case 5) a single positive smear and culture were obtained 24 hours after treatment was begun, but none subsequently. At that time the patient bad received 200,000 units.(3) The symptoms of acute salpingitis and peritonitis showed little or no improvement in 24 hours, but improved remarkably in 48 hours.(4) Cervical discharge changed from the profuse yellow character after three to six days to a white and mucoid type, decreasing thereafter.(5) The inflammation of acute salpingitis usually progressed for seven to ten days after treatment with penicillin and after the patients apparently had been freed of the gonococcus. Tubo-ovarian inflammatory masses and pelvic induration frequently appeared or progressed. Subsequently there were improvement and regression. Residual damage was found in all cases in this series, as adherent ovaries or chronic tubo-ovarian inflammatory masses. Such damage resulted regardless of whether or not palpable masses and induration were present before treatment.