Intrauterine infections - challenges in the perinatal period (literature review).

The purpose of the study is to summarize the literature data on the state of intrauterine infections that cause antenatal fetal abnormalities. MATERIALS AND METHODS: This article presents the assessment of 25 world literature sources from 2000 to 2016, which discuss the etiology of infectious agents acting on the fetus and causing a variety of pathological conditions. RESULTS: During gestation many researchers refer to the infection as one of the causes of antenatal fetal abnormalities. The etiology of intrauterine infection is diverse and differs between countries with different economic conditions. Detection of an infectious agent makes it possible to promptly carry out preventive measures, to improve hygiene standards in order to reduce the rate of infection transmission from mother to fetus. CONCLUSION: Timely detection of the etiology of intrauterine infections promotes the identification of high-risk groups giving a possibility to provide treatment in order to prevent the transmission of an infectious agent having direct economic benefits, especially in resource-poor countries with low and middle income.

Gynecological manifestations, histopathological findings, and schistosoma-specific polymerase chain reaction results among women with Schistosoma haematobium infection: a cross-sectional study in Madagascar.

BACKGROUND: The pathophysiology of female genital schistosomiasis (FGS) is only partially understood. This study aims to describe the histopathological findings, polymerase chain reaction (PCR) results, and gynecological manifestations of FGS in women with different intensities of Schistosoma haematobium infection. METHODS: Women aged 15-35 years living in an S. haematobium-endemic area in Madagascar underwent pelvic and colposcopic examinations. Small biopsy specimens were obtained from lesions and examined histopathologically. Schistosoma PCR was done on urine, biopsy, cervicovaginal lavage, and genital mucosal surface specimens. RESULTS: Sandy patches and rubbery papules were found in 41 of 118 women (35%). Rubbery papules reflected an intense cellular immune reaction dominated by eosinophils, epithelial erosion, and viable ova. There was a significant decrease in the prevalence of rubbery papules with age, even after adjustment for urinary ova excretion. The sandy patches with grains showed moderate cellular immune reaction and ova (viable and/or calcified). They were most prevalent in cases with low-intensity urinary S. haematobium infection. Forty-two percent of women with Schistosoma-negative urine specimens had at least 1 genital specimen test positive for Schistosoma by PCR. CONCLUSIONS: The results indicate a diversity of lesions caused by S. haematobium and a dynamic evolution of the genital lesions. Schistosoma PCR may give an indication of the diagnosis.

Characterization of the inflammatory response in the uteri of cows infected naturally by Neospora caninum.

Bovine neosporosis manifests during gestation, when the fetus may be vulnerable to pathogens. Experimental studies of Neospora caninum-infected cattle have been performed, but little is known about the in-utero inflammatory response. The aim of this study was to characterize the inflammatory response in the uteri of pregnant and non-pregnant cows infected naturally with N. caninum. Four groups of seven animals were studied. Two groups consisted of N. caninum-seropositive pregnant and non-pregnant cows and the other two groups contained N. caninum-seronegative pregnant and non-pregnant cows. Uterine and placental samples were subjected to immunohistochemistry using antibodies specific for N. caninum, CD4, CD8, CD14 and CD21. The non-pregnant seropositive and seronegative groups did not show a difference (P >0.05) in the types of cells present. There were more lymphocytes in the uteri of the seropositive pregnant animals (P <0.05) than in the seronegative pregnant animals, but this was not considered to be consistent with an inflammatory process. N. caninum cysts were detected in eight seropositive cows; five were non-pregnant and three were pregnant. CD4(+) T cells were distributed in the endometrium and myometrium of the non-pregnant cows and were sparse in the placentomes of pregnant cows. CD8(+) T cells were distributed in a similar manner, but were present in smaller number. There were no cells expressing CD14 or CD21. The results of the study suggest that there is no consistent uterine inflammatory response against N. caninum in naturally infected animals.

Primary uterine hydatid cyst: a case report.

Echinococcosis, which is caused by echinococcus granulosus, is also known as cystic hydatid disease, unilocular echinococcosis or cystic echinococcosis. Cystic echinococcosis is an alarming public health problem in some countries. Although the liver and lung are the organs involved most commonly by the disease, it may appear rarely in other tissues as a primary disease. Here, we present a 66-year-old patient who is invoved in farm work work. A Uterine multiseptate hydatid cyst was found on radiological investigations and the patient underwent surgery. A total hysterectomy was carried out. There were no postoperative complications.

Characterization of reproductive disorders in ewes given an intrauterine dose of Toxoplasma gondii tachyzoites during the intrauterine insemination.

The aim of this study was to characterize the reproductive disorders in the acute and chronic phases in ewes experimentally infected with different doses of Toxoplasma gondii during artificial insemination occurred. Animals (n=41) were divided into three experimental groups: in the group 1 (G1, n=15), animals were inseminated using contaminated semen containing 6.5×104 tachyzoites; in the group 2 (G2, n=15), animals were inseminated with contaminated semen containing 4×107 tachyzoites and in the group 3 (G3, n=11), animals were inseminated using tachyzoite-free semen, serving as control group. Parasitemia and seroconversion were observed in 28 of 30 and 20 of 30, respectively, from the seventh day after infection. Embryonic reabsorption was observed in the acute phase in ewes from G1 and G2. Persistent anestrus, hydrometra, mucometra and follicular cysts were observed in the second phase of the experiment in animals from G1 and G2. Histopathological lesions similar to those of toxoplasmosis were found in the placentas. In conclusion, artificial insemination using semen containing experimentally added tachyzoites can establish toxoplasmosis in ewes and cause reproductive pathologies during the acute and chronic phases of the disease.

A pregnant mouse model for bovine Tritrichomonas foetus infection.

The economically important effects of Tritrichomonas foetus infection in cattle are abortion and infertility, yet there has not been an animal model to examine the parasite-host interactions during gestation. In this study, 5- and 7- to 8-week-old BALB/cAnNCr, BALB/cJ, and SCID/NCr mice on a BALB/c background were intravaginally infected with T. foetus. All BALB/cAnNCr and BALB/cJ mice, and 89% of SCID/NCr mice sustained infections for 13 weeks, if inoculated before 5 weeks of age. Infection rates were lower in all mouse strains inoculated at 7 weeks of age, although BALB/cAnNCr mice were significantly more susceptible than BALB/cJ or SCID/NCr mice. Vaginal bacterial flora did not account for the variation in mouse-strain susceptibility, although coagulase-negative staphylococci in vaginal flora were associated with failure of T. foetus to infect. As with infected cattle, T. foetus-specific vaginal immunoglobulin (Ig) G and IgA antibodies were elevated after infection. The number and viability of day-10 fetuses were reduced in mice infected at 5 weeks of age and bred 12 weeks after infection. Lesions in pregnant and nonpregnant infected mice, including suppurative and eosinophilic vaginitis; cervicitis; endometritis with distension of the uterine lumen; endometrial ulceration; and glandular ectasia, with neutrophils in the glandular lumen and loss of gland epithelium, were similar to those in cattle. The decidua and placenta were multifocally necrotic. Immunohistochemistry demonstrated trichomonads in vaginal folds and uterine glands, and adjacent to fetal tissues. In summary, experimentally infected BALB/cAnNCr mice showed many pathologic similarities to cattle and may serve as a model to study host-trichomonad interactions.

Hidatidosis uterina: una localización excepcional / Uterine hydatid cyst: an exceptional location

La hidatidosis es una zoonosis de distribución mundial producida por helmintos del género Echinococcus. En Chile representa un problema de salud pública no resuelto aún en su totalidad. La localización ginecológica es poco frecuente, pero debe considerarse en el diagnóstico diferencial de masas pélvicas, sobre todo, en pacientes con infertilidad. Se presenta un caso clínico de hidatidosis pélvica primaria de origen uterino como hallazgo operatorio. Se discute el manejo y seguimiento.

The hydatid disease is a worldwide distribution zoonotic infection caused by a tapeworm of the genus Echinococcus. In Chile, it is a public health probiem that hasn't been completely solved yet. It is very unlikely to be found in ginecology. Still it has to be considered within pelvic mass study, mostly between infertile patients. We now discuss a surgical finding of a pelvic primary hydatid disease of uterine origin clinical case, the management and follow-up.

Intrauterine Neospora caninum inoculation of heifers and cows using contaminated semen with different numbers of tachyzoites.

OBJECTIVE: To investigate the potential of different Neospora caninum tachyzoite doses to infect heifers (experiment 1) and cows (experiment 2) when administered in utero by artificial insemination via contaminated semen. METHODS: In experiment 1, five groups of 5, 7, 8, 9, and 5 cyclic heifers were hormonally synchronized and artificially inseminated with semen containing 0 (A, controls), 10(2) (B), 5 x 10(3) (C), 5 x 10(4) (D), and 5 x 10(5) (E) live N. caninum NC-1 isolate-tachyzoites, respectively. Experimental infection was followed for 100 days. Parasitaemia and specific serum IgG, and interferon-gamma (IFN-gamma) responses were studied. In experiment 2, four groups of 9, 10, 9, and 9 adult multiparous cows with confirmed infertility problems of diverse aethiology were hormonally synchronized and artificially inseminated with semen containing 0 (a, controls), 10(2) (b), 5 x 10(3) (c), and 5 x 10(5) (d) live N. caninum NC-1 isolate-tachyzoites, respectively. Experimental infection was followed for 63 days. Parasitaemia and specific serum IgG responses were studied. RESULTS: In experiment 1, parasitaemia was detected in 1, 2, and 3 heifers from groups B, C, and D, respectively, between 9 and 23 days after insemination. Persistent specific serum antibody responses were detected in 2 and 3 heifers from groups D and E, respectively. Transient specific serum antibody responses were detected in 2, 1 and 1 heifers from groups C, D, and E, respectively. In addition, 1 heifer from group B showed a serum-specific antibody level higher than cut off value at 21 days post-insemination. Heifers seroconverted between 23 and 47 days after insemination. Specific IFN-gamma levels were detected in 1, 4, 6, and 3 heifers from groups B, C, D, and E, respectively, between 9 and 55 days after insemination. Pregnancy rate in the control group (60%) was higher than those observed in inoculated heifers (0-42.9%). Pregnancy rates in inoculated heifers were lower when the tachyzoite dose was increased (B 42.9%, C 12.5%, D 11.1%, and E 0%). In experiment 2, no Neospora DNA in blood nor specific serum IgG to N. caninum were detected in any of the cows studied, except in one cow inoculated with 5 x 10(5) tachyzoites (group d) which showed a relative index x100 (RIPC) values of 9.4, 18.9, and 18.1 at 42, 56, and 63 days after insemination, respectively. CONCLUSIONS: This study provides evidence that the intrauterine infection via contaminated semen using 5 x 10(4) and 5 x 10(5) tachyzoites caused persistent serum-specific antibody responses in some heifers. On the basis of serological data, a dose-response effect was also observed. In addition, N. caninum would be a probable cause of early foetal death in inoculated heifers. In contrast, results obtained in a similar experiment with cows showing confirmed infertility indicate that higher doses, such as of 5 x 10(5) tachyzoites, were necessary to induce seroconversion in at least one animal.

Schistosomiasis of the uterus in a patient with dysmenorrhoea and menorrhagia.

Abdominal hysterectomy was performed in a patient because of complaints of dysmenorrhoea and menorrhagia and the uterus was sent for histopathological analysis. Besides adenomyosis an extensive granulomatous infection with Schistosoma mansoni eggs was found.

Hydatid cyst of the uterus.

BACKGROUND: Hydatidosis is a common zoonosis that affects a large number of humans and animals, especially in poorly developed countries. The infesting parasite has four forms named Echinococcus granulosis, E. multilocularis, E. vogeli and E. oligarthrus (very rare in humans). The most frequently involved organs are liver followed by the lung. The involvement of the genital tract is rare and the occurrence in the uterus is an extreme rarity. We report a case of hydatid cyst in the uterus. CASE: A 70-year-old female with a history of hydatid cysts of the liver, was admitted to hospital after complaining of low abdominal pains. On physical and gynecological examinations, no pathological finding was detected. However, the uterus was significantly large for a postmenopausal patient. Transvaginal sonography (TS) revealed a cystic mass in the uterus with a size of 7 x 6 cm. After further examinations a subtotal hysterectomy was performed. Microscopic examination showed scolices of Echinococcus granulosis. CONCLUSION: Hydatid cysts in the genital tract are rare and the occurrence in the uterus is an extreme rarity. Differentiation between hydatid cyst and malignant disease of the related organ is difficult. To avoid misdiagnosis, a careful examination of pelvic masses should be carried out in endemic areas for detection of hydatid cysts.

Lymphatic filariasis of the ovary and mesosalpinx.

We report 2 cases of filariasis, one in the ovary and the other in the mesosalpinx. In the first case, the patient underwent panhystrectomy and in the second case, right ovarian cystectomy with right salpingectomy were performed under general anaesthesia. Histopathology showed adult filarial worms in the dilated lymphatics of the right ovary, in the first case and in the mesosalpinx, in the second case. Both patients presented with complaints related to gynecological problems and not filariasis. Reports of filariasis in the literature and possible treatments and prevention strategies are also discussed.

Trebius shiinoi n. sp. (Trebiidae: Siphonostomatoida: Copepoda) from uteri and embryos of the Japanese angelshark (Squatina japonica) and the clouded angelshark (Squatina nebulosa), and redescription of Trebius longicaudatus.

Trebius shiinoi n. sp. is described from females and males collected from the uterine linings and on embryos within the uteri of 2 near-term Japanese angelsharks (Squatina japonica Bleeker, 1858) captured in Suruga Bay, off central Japan, and from female specimens reported by Shiino in 1963 that were found on embryos of the clouded angelshark (Squatina nebulosa Regan, 1906) captured off Shirahama, central Japan. Shiino identified his specimens as Trebius longicaudatus Shiino, 1954. However, our comparisons between Shiino's specimens and those newly collected revealed both to represent the same species, and comparisons of these specimens to 5 syntypes of T. longicaudatus and to published information detailing other Trebius species revealed them to be a new species that differs most notably from its congeners by the enormous length of its transformed adult female's abdomen and by the presence of a distinctive nublike seta on her caudal ramus. Trebius shiinoi n. sp. is an unusual copepod because it is an endoparasite of adult female angelsharks as well as an ectoparasite of embryo angelsharks, and it is proposed that flushing of the uterine-cloacal chambers of clouded angelsharks and Japanese angelsharks may facilitate T. shiinoi infections. A redescription of T. longicaudatus is also provided.

Asherman syndrome caused by schistosomiasis.

BACKGROUND: Rare causes of Asherman syndrome include infections of the endometrium, such as tuberculosis and schistosomiasis. CASE: A 27-year-old Zulu woman, para 1, presented with secondary amenorrhea after an uncomplicated cesarean delivery. Hormone levels were in the normal ranges. Laparoscopy revealed some pelvic adhesions with patent fallopian tubes, and biopsy of the ovary showed schistosomiasis. Diagnostic D&C revealed a uterine cavity partially obliterated by adhesions. The patient was treated with praziquantel. CONCLUSION: Schistosomiasis should be considered as a possible cause of infertility and Asherman syndrome in those parts of the world where it is endemic.

Uterine hydatid cyst.

Hydatid cyst is a parasitic disease caused by Echinococcus. Although the first and most important site for this parasite is the liver, it can be seen in pelvic organs as well. However, primary involvement is very rare. We report and discuss a case with a primary involvement of the uterus which was operated and confirmed by microscopic studies. In conclusion, the gynecologist should be aware of the possibility of hydatid cyst when a septated cystic mass is found in the pelvis.

Colonization of the uterus by the oral protozoan Entamoeba gingivalis.

Pap smears occasionally reveal protozoa of the genus Entamoeba in the uterus of intrauterine device (IUD) users, but definitive identification of the species involved has not been possible. Using riboprinting, a technique that compares ribosomal RNA gene sequences, we present evidence that the organism is Entamoeba gingivalis, an inhabitant of the mouth. Colonization most likely occurs via orogenital contact and requires the presence of an IUD and a concomitant bacterial infection.

Induced Tritrichomonas foetus infection in beef heifers.

Four virgin beef heifers were inoculated intravaginally with 7 x 10(6) Tritrichomonas foetus organisms. Protozoal colonization of the vagina, cervix, and uterus developed within the first week after inoculation. Protozoa were no longer detected in secretions from these regions at approximately the same time in each heifer. Trichomonads were detected in reproductive tract secretions for 13 to 28 weeks. Eight weeks after clearance of trichomonads from the reproductive tract, a second infection was established in 2 of the 4 heifers by intravaginal inoculation of T foetus. The second infections were maintained for up to 4 weeks. The diagnostic sensitivity of wet-mount examination of the reproductive tract secretions was 30%, compared with 78% for culture of trichomonads in secretions. Collection and culturing of specimens of cervical and vaginal mucus provided the most reliable method for diagnosis of trichomoniasis during induced infection of heifers.