Herpetic salpingitis and fallopian tube prolapse

Aim: We describe the unusual association of fallopian tubal prolapse and he rpetic infection, an occurrence not previously reported to our knowledge. Methods and results: A 37-year-old woman presented with a small polypoid ma ss of the vaginal vault, 3 months after abdominal hysterectomy and abdomino plasty. The vaginal mass proved to be the fimbriated end of a fallopian tub e, herniated into the vagina. Reintervention 3 months later with resection of a small vaginal 'polyp' revealed a residual portion of fallopian tube, w ith superimposed herpes simplex virus (HSV) infection and marked cytologica l atypia of surface epithelial cells. HSV-2 immunostaining of viral nuclear inclusions and of atypical cells confirmed the herpetic nature of the infe ction. Conclusion: Involvement of the genito-urinary tract by HSV may occur via an ascending infection from the cervix, but the fallopian tube, deeply locate d in the pelvis, is generally spared from herpetic infection. In the settin g of fallopian tubal prolapse, direct exposure of the herniated fallopian t ube to various pathogens in the vagina provides an unique clinical model fo r salpingitis. In herpetic tubal infections, special attention must be paid to cytological atypia of probable viral cytopathogenic origin, to avoid a misdiagnosis of malignancy.