PLASMA-CELL ENDOMETRITIS IN WOMEN WITH SYMPTOMATIC BACTERIAL VAGINOSIS

Objective: To evaluate the endometrial microbiology and histopathology in women with symptomatic bacterial vaginosis but no signs or symptom s of upper genital tract disease or other vaginal or cervical infectio ns. Methods: Endometrial biopsies were performed on 41 women complaini ng of vaginal discharge or pelvic pain at a sexually transmitted disea se clinic. These women had neither culture nor serologic evidence of N eisseria gonorrhoeae or Chlamydia trachomatis infection. Twenty-two wo men with bacterial vaginosis diagnosed by Gram stain examination of va ginal fluid, but with neither signs nor symptoms of upper genital trac t infection, were compared with 19 women who had no evidence of bacter ial vaginosis on vaginal fluid Gram stain. Endometrial biopsies were e valuated for histopathologic evidence of plasma cell endometritis and were cultured for N gonorrhoeae, C trachomatis, aerobic and anaerobic bacteria, Mycoplasma species, and Ureaplasma urealyticum. Results: Ten of 22 women with bacterial vaginosis had plasma cell endometritis, co mpared with one of 19 controls (odds ratio [OR] 15, 95% confidence int erval [CI] 2-686; P < .01). Bacterial vaginosis-associated organisms w ere cultured from the endometria of nine of 11 women with and eight of 30 women without plasma cell endometritis (OR 12.4, 95% CI 2-132; P = .002). Conclusion: Plasma cell endometritis was frequently present in women with bacterial vaginosis and without other vaginal or cervical infections. This suggests the possibility of an association between ba cterial vaginosis and nonchlamydial, nongonococcal, upper genital trac t infection.