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To investigate the role of Chlamydia trachomatis in puerperal endometritis, 72 patients with endometritis following vaginal or cesarean section delivery were studied. Blood, urine and endometrial cultures for aerobic and anaerobic bacteria and for C trachomatis were performed for all patients. C trachomatis was isolated in 25% of patients with endometritis. Patients with post-vaginal-delivery endometritis and a positive C trachomatis culture had a later onset of infection as well as a favorable clinical response to treatment despite persistence of C trachomatis in their endometrial cultures at the end of therapy. Cephalosporins failed to eradicate C trachomatis from endometrial cultures after five days of intravenous therapy.
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