Analysis of chronic endometritis for Chlamydia trachomatis by polymerase chain reaction.

Chronic endometritis is characterized histologically by plasma cells infiltrating endometrial stroma. Although it has been speculated that many instances of chronic endometritis are infectious, the origin of most cases is not apparent by routine histopathologic evaluation. Chlamydia trachomatis, an obligate intracellular bacterium, is known to cause chronic endometritis in the setting of pelvic inflammatory disease. The authors analyzed 43 specimens of histopathologically diagnosed chronic endometritis from 38 patients for C trachomatis by PCR using primers for the single-copy major outer membrane protein (MOMP) gene. C trachomatis was detected in only one such case in which dense plasma cell infiltrates were present and concurrent C trachomatis infection of the cervix was documented. Using serially diluted DNA from formalin-fixed, paraffin-embedded McCoy cells, the sensitivity of this method was shown to be equivalent to a single infected cell in a paraffin section. In conjunction with the results of other studies, these data indicate a limited role, if any, of C trachomatis in the origin of mild or moderate chronic endometritis.