Salpingitis in Non-Sexually Active Girls: Clinical Spectrum and Diagnostic Clues from a Pediatric Cohort

Background: Pediatric salpingitis is rare and often underrecognized, especially in nonsexually active girls in whom symptoms are non-specific and sexually transmitted infections are absent. Delayed diagnosis may increase the risk of complications. We aimed to characterize the clinical presentation, diagnostic features, management, and outcomes of pediatric salpingitis and to identify predisposing factors in non-sexually active pediatric patients. Methods: We retrospectively reviewed pediatric cases of radiologically or surgically confirmed salpingitis at a tertiary children’s hospital (2000–2025) and conducted a narrative review of published pediatric cases. Results: Ten non-sexually active girls were included (median age 12.8 years). Abdominal pain was the most common symptom (80%), followed by fever and gastrointestinal complaints (50% and 30%, respectively); two patients (20%) were asymptomatic. Hydrosalpinx or pyosalpinx was detected on ultrasound in 80%. A causative organism was identified in 30%, predominantly enteric or anaerobic flora. All patients received broad-spectrum intravenous antibiotics; half required procedural or surgical intervention. Clinical outcomes were favorable in all cases. The literature review identified 56 additional non-sexually active girls, most of whom were postmenarchal. Abdominal pain was the predominant presentation, and gastrointestinal or anatomical predisposing factors were common. Conclusions: Non-sexually transmitted salpingitis is an uncommon but clinically relevant condition in children. Its atypical and often subtle presentation in non-sexually active girls warrants heightened clinical awareness. Early imaging and attention to gastrointestinal or postsurgical antecedents can facilitate timely diagnosis. Further multicenter studies are needed to establish diagnostic criteria and clarify long-term reproductive outcomes.