Chronic endometritis is a localized chronic inflammation of the endometrial mucosa. It can be associated with pelvic inflammatory disease and/orsexually-transmitted disease. Molecular diagnostics are probably the most efficient way to establish a pathogen.
Histologic features of the endometrial mucosa
(1) variable mucosal edema
(2) plasma cell infiltrate, which may vary from scant to numerous
(3) increased stromal cell density
Neutrophils may occur during the menstrual cycle so their presence may be nondiagnostic.
The degree of inflammation may correlate with features seen at hysteroscopy.
Pathogens associated with chronic endometritis include:
(1) Chlamydia trachomatis
(2) Mycoplasma hominis
(3) Neisseria gonorrhoeae
(4) Enterococcus
(5) Escherichia coli
(6) Gardnerella vaginalis
(7) Klebsiella species
(8) Staphylococcus species
(9) Streptococcus species
