[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Female genital tract](https://durgical.com/en/general-pathology/areas/female-genital/) › Acute and chronic endometritis # Acute and chronic endometritis - Lesion Infection of the endometrium follows delivery, abortion or devices; neutrophils mark the acute form and plasma cells the chronic one. Updated Nov 12, 2026 ## Key points - Acute endometritis: neutrophils in the stroma and glands, usually after delivery, miscarriage or instrumentation with retained products. - Chronic endometritis: plasma cells in the stroma are the diagnostic finding (CD138 highlights them). - Causes of chronic endometritis: pelvic inflammatory disease (Chlamydia, gonococcus), retained products, intrauterine devices, tuberculosis. - Genital tuberculosis reaches the tubes by blood and then the endometrium; caseating granulomas; an important cause of infertility where tuberculosis is common. - Repeated curettage of an infected uterus can leave intrauterine adhesions (Asherman syndrome). ## What it is The endometrium resists infection because it is shed each month, so endometritis usually needs a trigger. Acute endometritis follows delivery or abortion, especially with retained tissue, and is caused by bacteria such as group A or B streptococci and staphylococci. Chronic endometritis is defined by plasma cells in the stroma and accompanies pelvic inflammatory disease, retained products of conception, intrauterine devices and tuberculosis; it causes bleeding, pain and infertility. ## Structure - Acute: neutrophilic infiltrate, microabscesses and necrotic decidua or villi when products of conception are retained. - Chronic: plasma cells and lymphocytes in the stroma, sometimes lymphoid follicles; glands may look out of phase and the stroma spindled. - Tuberculous: granulomas, which form best in secretory endometrium and are often small because the lining is shed. ## Step by step - Delivery, abortion or instrumentation opens the cervix and leaves damaged tissue in the uterus. - Bacteria from the vagina or the skin colonise the retained tissue and the raw placental bed. - Neutrophils invade (acute endometritis); infection can extend to the myometrium and parametria and cause sepsis. - If the trigger persists (device, retained tissue, untreated sexually transmitted infection), the infiltrate becomes chronic with plasma cells. - Inflammation and repair can scar the lining and the tubes and reduce fertility. ## Clinical notes - Postpartum endometritis causes fever, uterine tenderness and foul lochia; it is the commonest cause of puerperal fever. - Chronic endometritis causes irregular bleeding, pelvic pain and recurrent implantation failure or miscarriage. - In Colombia and other regions where tuberculosis is common, genital tuberculosis should be considered in infertility with an abnormal biopsy. ## Memory aid Neutrophils come after the birth; plasma cells stay when the cause stays. ## Test yourself Think of the answer, then tap the question to see it. ## Which cell defines chronic endometritis? The plasma cell in the endometrial stroma. ## What usually triggers acute endometritis? Delivery, miscarriage or abortion, especially with retained products of conception that bacteria colonise. ## How does tuberculosis reach the endometrium? By blood to the fallopian tubes first, then by extension to the endometrium, where it forms granulomas. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/general-pathology/acute-and-chronic-endometritis/) [More Pathology questions →](https://durgical.com/en/practice/?f=pathology) ## Elsewhere in DurgiPedia - [Uterus and the endometrial cycle](https://durgical.com/en/histology/uterus-and-the-endometrial-cycle/) ## Connections ## Related 6 - [Pelvic inflammatory disease](https://durgical.com/en/general-pathology/pelvic-inflammatory-disease/) - [Spontaneous abortion](https://durgical.com/en/general-pathology/spontaneous-abortion/) - [Endometrium and abnormal uterine bleeding](https://durgical.com/en/general-pathology/endometrium-and-abnormal-uterine-bleeding/) - [Diseases of the fallopian tube](https://durgical.com/en/general-pathology/diseases-of-the-fallopian-tube/) - [Chronic inflammation: causes, cells and features](https://durgical.com/en/general-pathology/chronic-inflammation-causes-cells-and-features/) - [Granulomatous inflammation: caseating vs non-caseating, the causes to know](https://durgical.com/en/general-pathology/granulomatous-inflammation-caseating-vs-non-caseating-the-causes-to-know/) ## Related conditions 7 - [Puerperal infection (postpartum endometritis and maternal sepsis)](https://durgical.com/en/conditions/puerperal-infection/) - [Septic and unsafe abortion](https://durgical.com/en/conditions/septic-and-unsafe-abortion/) - [Pelvic inflammatory disease](https://durgical.com/en/conditions/pelvic-inflammatory-disease/) - [Miscarriage (early pregnancy loss)](https://durgical.com/en/conditions/miscarriage/) - [Tuberculosis](https://durgical.com/en/conditions/tuberculosis/) - [Asherman syndrome (intrauterine adhesions)](https://durgical.com/en/conditions/asherman-syndrome/) - [Female infertility](https://durgical.com/en/conditions/female-infertility/) ## Microorganisms 5 - [Streptococcus pyogenes](https://durgical.com/en/microbiology/streptococcus-pyogenes/) - [Streptococcus agalactiae](https://durgical.com/en/microbiology/streptococcus-agalactiae/) - [Chlamydia trachomatis](https://durgical.com/en/microbiology/chlamydia-trachomatis/) - [Mycobacterium tuberculosis](https://durgical.com/en/microbiology/mycobacterium-tuberculosis/) - [Actinomyces israelii](https://durgical.com/en/microbiology/actinomyces-israelii/) [← All of general pathology](https://durgical.com/en/general-pathology/) Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given. Sources: [Pelvic Inflammatory Disease](https://www.ncbi.nlm.nih.gov/books/NBK499959/) (StatPearls (NCBI Bookshelf), 2026); [Chlamydia trachomatis Infection](https://www.ncbi.nlm.nih.gov/books/NBK537286/) (StatPearls (NCBI Bookshelf), 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/general-pathology/acute-and-chronic-endometritis/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/acute-and-chronic-endometritis/