Female reproductive system

disorders
Dr. T. Ibnu Alferraly, Sp.PA
Dr. Juliana Lina,Sp.PA
Bagian Patologi Anatomi
FK-UISU / 2013

 Infectious diseases of the female

genital tract are common and
are caused by many pathogenic
organisms.
Most of the important infectious
diseases affecting the female
genital tract are sexually
transmitted.

Bacterial Infections
Neisseria gonorrhoeae cause of
acute salpingitis and pelvic
inflammatory disease (PID)
(tuboovarian abscess).
Chlamydia trachomatis
Trichomonas vaginalis25% of
asymptomatic carriers women
manifests as a heavy, yellow-gray,
thick, foamy discharge, severe itching,
dyspareunia, and dysuria.

Viral Infections
Human papillomavirus (HPV)
Wart-like lesions as verrucae and
condylomata (HPV types 6,11).
Herpes simplex type 2
Small vesicles develop on the vulva and
erode into painful ulcers.
Epithelial cells adjacent to
intraepithelial vesicles show ballooning
degeneration and many contain large
nuclei with eosinophilic inclusions.
Diagnosed by cervical Pap smear.

Pelvic Inflammatory Disease (PID)

An infection of pelvic organs that follows extension
of any of a variety of microorganisms beyond the
uterine corpus.
Ascent of the infection results in bilateral acute
salpingitis, pyosalpinx, and tuboovarian
abscesses.
N. gonorrhoeae and chlamydia are the principal
organisms causing PID, but most infections are
polymicrobial.
The incidence of PID is far greater in sexually
promiscuous women than in those who are
monogamous. Occasionally, PID is a sequel to
postpartum endometritis or a complication of
endometrial curettage.

 Patients with PID typically present with

lower abdominal pain. Complications of
PID include (1) rupture of a tuboovarian
abscess, which may result in lifethreatening peritonitis; (2) infertility from
scarring of the healed tubal plicae; (3)
increased rates of ectopic pregnancy; and
(4) intestinal obstruction from fibrous
bands and adhesions.

Cervicitis
Inflammation of the cervix is common and is
related to constant exposure to bacterial
flora in the vagina.
Acute and chronic cervicitis result from
infection with many microorganisms,
particularly endogenous vaginal aerobes and
anaerobes, Streptococcus, Staphylococcus,
and Enterococcus, Chlamydia trachomatis,
Neisseria gonorrhoeae, and occasionally
herpes simplex, type 2.

 Pathology:
In acute cervicitis, the cervix is grossly
red, swollen, and edematous, with
copious pus dripping from the external
os. Microscopically, the tissues exhibit an
extensive infiltrate of polymorphonuclear
leukocytes and stromal edema.
In chronic cervicitis, which is more
common, the cervical mucosa is
hyperemic, and there may be true
epithelial erosions. Microscopically, the
stroma is infiltrated by mononuclear
cells, principally lymphocytes and plasma
cells. Metaplastic squamous epithelium of
the transformation zone may extend into
endocervical glands, forming clusters of

Salpingitis
Salpingitis is inflammation of the fallopian
tubes, typically due to infections
ascending from the lower genital tract.
Neisseria gonorrhoeae, Escherichia coli,
Chlamydia, and Mycoplasma.
Acute episodes of salpingitis (particularly
those associated with chlamydial
infection) may be asymptomatic. A
fallopian tube damaged by prior infection
is particularly susceptible to reinfection. In
most cases, chronic salpingitis develops
only after repeated episodes of acute

 In acute salpingitis, microscopic examination

reveals marked infiltration by
polymorphonuclear leukocytes,
pronounced edema, and congestion of the
mucosal folds (plicae).
The inflammatory infiltrate in chronic salpingitis
consists of lymphocytes and plasma cells.
Edema and congestion tend to be minimal.
In late stages, the fallopian tube may seal and
become distended with pus (pyosalpinx) or a
transudate (hydrosalpinx).
The fallopian tube allows ascending
microorganisms from the lower genital tract to
reach the peritoneal cavity, leading to peritonitis
and PID. The adjacent ovary may also be
involved, sometimes giving rise to a tuboovarian abscess.

Chorioamnionitis Results from Ascending Infection

Is inflammation of the amnion,

chorion, and extraplacental
membranes. Infectious organisms
ascend from the maternal birth
canal, commonly after premature
rupture of the membranes.
Mycoplasmas hominis, anaerobic
organisms of the Bacteroides group,
aerobes (group B streptococci, E.
coli, and Gardnerella vaginalis.

 Clinical Features:
Acute chorioamnionitis is found in 10% of
placentas and is associated with preterm
labor, fetal and neonatal infections, and
intrauterine hypoxia.
The risks of chorioamnionitis to the fetus
include (1) pneumonia after inhalation of
infected amniotic fluid, (2) skin or eye
infections from direct contact with
organisms in the fluid, and (3) neonatal
gastritis, enteritis, or peritonitis from
ingesting infected fluid.
Major risks to the mother are intrapartum
fever, postpartum endometritis, and
pelvic sepsis with venous thrombosis.

INFLAMMATIONS
ACUTE MASTITIS bacterial infection
of the breast abscess
COMEDOMASTITIS DUCT ECTASIA=
Plasma Cell Mastitis.
Traumatic fat necrosis is an
uncommon mostly trauma to the
breast hemorrhage necrosis of
adipocytes + inflamm cell phagocytes
lipid debris (limfosit + giant cell).