Prevalence and manifestations of endometritis among women with cervicitis. Paavonen J , Kiviat N , Brunham RC , Stevens CE , Kuo CC , Stamm WE , Miettinen A , Soules M , Eschenbach DA , Holmes KK . Thirty-five women referred from an STD Clinic, because of suspected cervicitis, studied for the presence of endometritis by transcervical endometrial biopsies and cervical and endometrial cultures.
Fourteen (40%) of the patients had histologic evidence of endometritis.
Findings that significantly correlated with endometritis included a history of intermenstrual vaginal bleeding, the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, or Streptococcus agalactiae in the cervix, and the presence of serum antibodies to C. trachomatis or to Mycoplasma hominis.
In non-PID patients, Chlamydia and anaerobes in the cervix / vagina ascend to the endometrium in 45-60% of cases (only 20% for N. gonorrhoeae ).
Outpatient regimens are effective in eradicating N. gonorrhoeae from the endometrium and although C. trachomatis and anaerobic flora are variably reduced (<50%), they are not eliminated from the endometrium.
Ofloxacin and clindamycin appear to be more effective in clearing the endometrium of anaerobic organisms than ceftriaxone and doxycycline, but (at 4 weeks) appear to be no different in improving histopathologic evidence of endometritis.