Case 145. Entamoeba gingivalis-related endometritis (53 y-o F)
         
    Smear from the white material around the removed intrauterince contraceptive device    
         
   
Key words : Entamoeba gingivalis, Actinomyces israelii, endometritis
   
         
   
sexually transmitted infection
   
     
 
     
In the necrotic background, grains of Actinomyces israelii are observed.   In the necrotic exudate, amebic trophozoites with centrally located keryosome are dispersed. Mixed infection of Actinomyces and Entamoeba gingivalis is indicated.
     
 
     
PCR analysis of E. gingivalis DNA
Cells in the cytology specimen were collected for the PCR analysis. A 221 base pair band was obtained, and the sequence analysis was consistent with E. gingivalis. Prolonged use of the IUD provides a chance for anaerobic microbes to grow. Both A. israelii and E. gingivalis are the anerobic normal flora of the oral cavity. Infection was apparently transmitted by oral sex.
  Reference case 145A
Entamoeba gingivalis in the dental socket (smear preparation from a patient with alveolar pyorrhea, Papanicolaou). Neutrophil-phagocytizing ameba trophozoites are increased in case of parodontitis. Numerous bacteria are observed in the background. The ameba is usually non-pathogenic.
     
 
     
Reference case 145A
Leukophagocytosis is characteristic of E. gingivalis. Filamentous rods are seen in the background (Papanicolaou, oil immersion). In contrast to E. histolytica which often phagocytizes red cells, E. gingivalis actively phagocytizes neutrophils.
  Reference case 145A
Vacuolated cytoplasm seen in E. gingivalis in the dental socket (Giemsa, oil immersion). Encystation is not seen. The pathogen lacks mitochondria, so that it is an obligate anaerobe.