III. Infections
Objectives:
After completing this section you will be able to:
- list common infectious diseases of the endometrium
- specify etiologic agent and mode of diagnosis
- describe clinical presentation
- recognize diagnostic histologic features of endometrial inflammation
- Acute endometritis
This usually occurs after an abortion either spontaneous or induced, pregnancy
or medical instrumentation. The organisms involved include Staphylococci,
Streptococci, N. gonorrhoeae, gram-negative bacilli and occasionally fungi
and viruses.
The findings in most cases are non-specific, as they do not usually point
to a specific agent.
- Chronic endometritis
Chronic endometritis is associated with IUD use, PID, and retained products
of conception following an abortion or delivery. The etiologic agent is often
not apparent and the patient is said to have non-specific chronic endometritis.
About half of these cases have C. trachomatis or N. gonorrhoeae infection.
Other causative organisms include Mycoplasma.
Patients present with irregular bleeding.
Histologically, the presence of plasma cells in the endometrium is diagnostic.
Maturation of the endometrium is irregular making histologic dating difficult.
The stromal cells become spindled and swirl around the glands.
Chronic endometritis.
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