Management of fungal endometritis

Fungal endometritis is a generalised term that describes infection of the uterus with either a yeast or mould. They are heterotrophic, aerobic or facultative anaerobic, nonmotile organisms [1,2]. The incidence of fungal endometritis identified by uterine culture is believed to be 1–5% [1]. These infections primarily consist of Candida spp., Aspergillus spp. or Mucor spp. [1,2]. The primary reservoir for organisms that infect the uterus is the caudal reproductive tract including the vagina and external genitalia [1]. Poor perineal conformation allowing contamination of the reproductive tract from the environment, repeated/lengthy intrauterine antibiotic treatment and excessive reproductive manipulation have all been implicated as potential causes of fungal invasion of the uterus [3]. Mares that have been identified as having poor uterine defence mechanisms with decreased ability to clear fluid/organisms from their uterus may then provide an environment for opportunistic fungi to proliferate and cause endometritis [1,4]. Immunocompromise, endocrine disorders and hormonal therapy may also predispose the endometrium to fungal infections ...