Endometritis
Endometritis is an upper genital tract infection and is characterized by inflammation of the uterine lining, involving the endometrium and the underlying glandular tissues.(Eckert & Lentz, 2007) Etiology for endometritis may be infections for instance; gonorrhea, chlamydia, tuberculosis, or a combination of normal vaginal bacteria.(Zieve, 2011) Endometritis usually coexists with other infections such as acute salpingitis, acute cervicitis, and other sexually transmitted infections.(Eckert & Lentz, 2007; Zieve, 2011) The symptoms associated with endometritis are swelling or abdominal distention; pain experienced in the lower abdomen or pelvic region, abnormal vaginal bleeding and discharge, general discomfort, constipation, fever and malaise. The risk factors associated with development of endometritis are medical procedure such as hysteroscopy and placement of an intrauterine device.(Zieve, 2011)
The corner stone of diagnosis of endometritis is endometrial biopsy. Other medical procedures and tests involved are ESR (sedimentation rate), laproscopy, white blood count, microscopic examination of the cervical discharge. The histopathological criterion of endometritis is the presence of plasma cell in endometrial stroma along with five or more neutrophils in endometrial lining. In case a patient has severe endometritis, diffuse lymphocytes and plasma cells may be present in the endometrial stroma.(Eckert & Lentz, 2007) According to the CDC 2010 guidelines, the following are recommended for patients with endometritis: ceftriaxone, cefoxitin plus probenecid or other parenteral third-generation cephalosporin (e.g., ceftizoxime, cefotaxime) plus doxycycline with or without metronidazole. (Workowski & Berman, 2010) Endometritis if left untreated can result in more serious complications and infections.
Take away points:
Endometritis is an upper genital tract infection and is characterized by inflammation of the uterine lining, involving the endometrium and the underlying glandular tissues
Endometritis usually coexists with other infections such as acute salpingitis, acute cervicitis, and other sexually transmitted infections
The corner stone of diagnosis of endometritis is endometrial biopsy
References
Eckert, L. O. & Lentz, G. M. (2007). Infections of the Lower and Upper Genital Tracts. In V.L.Katz (Ed.), Comprehensive gynecology (5th ed., pp. 543-544). Mosby Elsevier.
Workowski, K. A. & Berman, S. (2010). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm.Rep., 59, 1-110.
Zieve, D. (2011). Endometritis. PubMed Health Website [On-line]. Available: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002454/
