Ascending herpetic endometritis

Two cases of herpetic endometritis are reported. In both patients, the disease developed from documented herpetic cervicitis via transcervical ascension. One patient recovered spontaneously. Generalization and death occurred in the other patient, a renal transplant recipient treated with immunosuppressive agents. The histologic features of herpetic endometritis are illustrated. Intranuclear inclusions and ground-glass nuclei were found in endometrial glandular and stromal cells. Focal necrosis was prominent. Herpetic virus particles were demonstrated by electron microscopy in both cases. Ascending herpetic endometritis is a rare complication of a common disease. In patients with deficiencies of the immune system, herpetic endometritis may represent the initial step toward dissemination and warrants particular attention.