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Metritis is
inflammation Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...
of the wall of the
uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uter ...
, whereas
endometritis Endometritis is inflammation of the inner lining of the uterus ( endometrium). Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge. It is the most common cause of infection after childbirth. It is also p ...
is inflammation of the functional lining of the uterus, called the
endometrium The endometrium is the inner epithelial layer, along with its mucous membrane, of the mammalian uterus. It has a basal layer and a functional layer: the basal layer contains stem cells which regenerate the functional layer. The functional laye ...
. The term pelvic inflammatory disease (PID) is often used for metritis.


Definitions

Postpartum metritis Postpartum infections, also known as childbed fever and puerperal fever, are any bacterial infections of the female reproductive tract following childbirth or miscarriage. Signs and symptoms usually include a fever greater than , chills, lower a ...
, also known as puerperal sepsis, occurs within 21 days and is most common within 10 days of delivery. Metritis is characterized by an enlarged uterus and a watery red-brown fluid to viscous off-white purulent uterine discharge, which often has a bad smell. The severity of disease is categorized by the signs of health: *Grade 1 metritis: An abnormally enlarged uterus and a purulent uterine discharge without any systemic signs of ill health. *Grade 2 metritis: Animals with additional signs of systemic illness such as decreased milk yield, dullness, and fever >39.5 °C. *Grade 3 metritis: Animals with signs of toxemia such as inappetence, cold extremities, depression, and/or collapse. Clinical endometritis is defined in cattle as the presence of a purulent uterine discharge detectable in the vagina 21 days or more postpartum. Simple grading systems for clinical disease are based on the character of the vaginal mucus and typical Grading schemes for clinical endometritis are widely used by veterinarians. Subclinical endometritis is characterized by inflammation of the endometrium and the presence of neutrophils in cytology or biopsy histology, in the absence of signs of clinical endometritis.


Other animals

These terms can apply to any species of mammal. Amongst domestic animals, metritis and endometritis are most common in cattle after parturition, and the diseases are often called postpartum metritis or postpartum endometritis. These diseases in cattle are caused by bacteria and occasionally viruses. The most common bacteria that cause postpartum metritis and endometritis in cattle are ''Escherichia coli'', ''Trueperella'' (previously ''Arcanobacterium'') ''pyogenes'' and anaerobic bacteria such as ''Prevotella'' species and ''Fusobacterium necrophorum''. The virus most consistently associated with postpartum uterine disease in cattle is Bovine Herpesvirus 4 (BoHV-4). In addition, "Several specific diseases are associated with metritis or
endometritis Endometritis is inflammation of the inner lining of the uterus ( endometrium). Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge. It is the most common cause of infection after childbirth. It is also p ...
. These include
brucellosis Brucellosis is a highly contagious zoonosis caused by ingestion of unpasteurized milk or undercooked meat from infected animals, or close contact with their secretions. It is also known as undulant fever, Malta fever, and Mediterranean fever. The ...
,
leptospirosis Leptospirosis is a blood infection caused by the bacteria ''Leptospira''. Signs and symptoms can range from none to mild (headaches, muscle pains, and fevers) to severe ( bleeding in the lungs or meningitis). Weil's disease, the acute, severe ...
, campylobacteriosis, and trichomoniasis" The Merck Veterinary Manual, "Metritis and Endometritis"
/ref> In cattle, bacterial infection of the uterus affects almost all animals after parturition. This does not mean they will get disease. Beef cattle rarely have disease unless they have a predisposing factor such as retained placenta or difficult parturition. However, uterine disease is common in
dairy cattle Dairy cattle (also called dairy cows) are cattle bred for the ability to produce large quantities of milk, from which dairy products are made. Dairy cattle generally are of the species ''Bos taurus''. Historically, little distinction was mad ...
- particularly high-milk-yield cows such as Holstein-Friesian cows.
Contagious equine metritis Contagious equine metritis (CEM) is a type of metritis (uterine inflammation) in horses that is caused by a sexually transmitted infection. It is thus an equine venereal disease of the genital tract of horses, brought on by the '' Taylorella equig ...
is a
sexually transmitted infection Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are Transmission (medicine), spread by Human sexual activity, sexual activity, especi ...
in horses, recognized since 1977. In 2014 a study reported about the first successful
vaccination Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating ...
trials in
cattle Cattle (''Bos taurus'') are large, domesticated, cloven-hooved, herbivores. They are a prominent modern member of the subfamily Bovinae and the most widespread species of the genus ''Bos''. Adult females are referred to as cows and adult mal ...
. The infection rate declined significantly.Vinícius Silva Machado, Marcela Luccas de Souza Bicalho u. a.: ''Subcutaneous Immunization with Inactivated Bacterial Components and Purified Protein of Escherichia coli, Fusobacterium necrophorum and Trueperella pyogenes Prevents Puerperal Metritis in Holstein Dairy Cows.'' In: ''PLoS ONE.'' 9, 2014, S. e91734, .


Etymology and pronunciation

The word ''metritis'' ( or ) uses combining forms of '' metr-'' + ''
-itis Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...
'', yielding "uterus inflammation".


References

{{reflist Mammal diseases