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Aerobic organisms include streptococci, Gardnerella vaginalis, Escherichia coli, Staphylococcus aureus, and group A β-hemolytic streptococci. Endometritis that occurs late in the postpartal period is most commonly caused by Chlamydia trachomatis.
Abdominal tenderness is common. Severe endometritis may cause fever, chills, tachycardia, extreme uterine tenderness, and subinvolution. Although a moderate-to-profuse foul-smelling vaginal discharge usually is seen, the lochia of women infected by β-hemolytic streptococci is scant, odorless, and serosanguineous to serous.
Antibiotics that treat aerobic and anaerobic bacteria are administered, usually for a 4- or 5-day course. Supportive therapy includes bedrest, analgesics, and oral and IV fluids.