{"paper_id":"7c92bb42-df2e-4276-8bdc-9c0f841fac93","body_text":"Low reproductive efficiency in camelids was defined as a significant problem [ 1 ]. The camel reproductive performance under natural conditions has been widely suggested to be low [ 2 ]. Hence, reproductive disorders are essential to recognize, especially when dealing with genetically superior animals. In general, repeat breeding, refuse to mate, and difficulties in the mating process have been reported as common owner’s complaints in female camels.\nUterine infections, ovulation failure, and management errors were the real reasons for camel infertility [ 3 ]. Genital defects have a significant financial influence on animal production by causing subfertility in animal breeding. Uterine disorders post-partum affect fertility by delaying uterine involution, decrease milk output, and impact the health of the animal in general [ 4 ]. As in many domestic animal species, uterine infections in she-camels were correlated with repeated breeding diseases [ 5 ]. Since the 1980s, many prevalence surveys have been carried out in Saudi Arabia on reproductive defects [ 6 – 8 ], in the United Arab Emirates [ 9 ], with variable prevalence. The difference in these prevalence rates presumably concerns the application of different methods of diagnosis with variable tests and the use of different classification systems to determine abnormalities.\nAs compared to other animal species, there are many gaps in the understanding of the etiology and pathogenesis and evolution of genital disorders in camelids. Failure of early diagnosis and providing appropriate treatment may result in serious outcomes.\nReproductive efficiency increases are crucial for profitable production and also genetic improvement and selection of camel breeds.\nTherefore, the diagnosis of reproductive disorder should occur first. Histopathological studies and isolation from the uterus are essential to identify and manage reproductive performance and circumvent reproductive disorders [ 10 ]. Camel abnormalities based on abattoir surveys of specimens could provide valuable data regarding the prevalence and incidence of reproductive disorders. In the camel, the histopathological criteria of reproductive abnormalities are largely understudied. For this reason, this study was carried out to obtain further information on the prevalence of the uterine, cervical, and vaginal lesions of she-camels slaughtered in Egypt as well as to identify their pathological problems at gross and histological levels and to isolate bacteria, fungi, and even virus from organs with abnormalities. A trial to correlate the isolated pathogens incorporated with those pathologies with probable zoonotic importance was carried out.\n\nThe genital tract of 500 adult non-pregnant female camels slaughtered in three abattoirs such as El-basateen, Elmonib, and Kerdasa abattoirs, Giza, Egypt, was collected and examined during the period from January 2016 to January 2018. Information about the clinical history of the animals was lacking. Reproductive organs of camel were carefully removed aseptically as possible for further examination procedures. The protocol of the current work was approved by the Institutional Animal Care and Use Committee at Cairo University, CUIIFC3118.\nGross examination was carried out on the uterus, cervix, and vagina of each case immediately following procedures of slaughtering, and any abnormalities were recorded. The specimens of each tract were numbered, including uterus, cervix, and vagina, placed in separate sterile plastic bags, and kept frozen at −20°C. The specimens were then brought to the laboratory for bacteriological, mycological, and virological examinations, in addition to the uterine fluid that aspirated from cases with hydrometra and pyometra, at which fluid and pus were separately collected by 5-ml sterile syringe. For histopathological and morphometrically examinations, another specimen from the previous organs was fixed in 10% buffered neutral formalin.\nFormalin-fixed tissue specimens of the previously mentioned organs were routinely processed for H&E staining. The specimens were dehydrated in a series of alcohol, followed by clearing in xylene and finally embedded in paraffin. Sections of about 4–6-μm thickness were obtained from each paraffin block and then were routinely stained with hematoxylin and eosin (H&E) according to Bancroft and Gamble [ 11 ]. Special stains were used on need, including Massons’ trichrome stain, periodic acid Schiff, Prussian blue, and Gram stain Bancroft and Gamble [ 11 ].\nIn some selected pathological lesions, five random high microscopic fields per tissue section were analyzed using a computer-aided microscopic image analyzer connected to a full HD microscopic camera (Leica Microsystems, Germany).\nThe samples sent for microbiological examination were only for those organs which showed pathological abnormalities (196 specimens). Bacteriological examination was performed on the collected uterine, cervical, and vaginal specimens and the aspirated uterine pus and fluid samples using standard protocols [ 12 ]. Tissue samples were minced with sterile scissors and forceps. All the samples were plated onto blood agar for  Streptococcus  and  Corynebacterium  species, MacConkey agar (Oxoid), eosin methylene blue agar (Oxoid) for  Enterobacteriaceae , Pseudomonas agar base containing (C-N) supplement (Oxoid ) for  Pseudomonas  species, Rappaport-Vassiliadis medium with soya (RVS broth), xylose lysine deoxycholate agar (XLD agar) for Salmonella species, Baird parker agar for  Staphylococcus aureus,  dextrose tryptone agar medium for Bacillus species, and sabouraud dextrose agar with chloramphenicol for  Candida albicans . The cultures were incubated at a temperature of 37°C for 24–48 h except for sabouraud dextrose agar at 25°C for 5–7 days. Suspected colonies were further examined for colony morphology, Grams characteristics, and motility, according to Brenner and Farmer [ 13 ] and Elias et al. [ 14 ]. Gram-negative bacilli and Gram-positive cocci were subjected to standard biochemical tests, according to Quinn et al. [ 12 ]. API 20 NE, RapID TM  ONE (Remel), and Staphytect Plus kit were used for further identification for  Pseudomonas  spp., Enterobacteriaceae, and  S. aureus,  respectively .\nDNA extraction: the extraction of DNA from genital organs was performed using the DNeasy Blood &Tissue Kit (Qiagen, Germany) according to the manufacturer’s instruction. The extracted DNAs were stored at−20°C till use. Polymerase chain reaction (PCR) for the genus-specific Brucella cell surface salt extractable 31 kDa protein gene was performed using forward primer B4 (59 TGG CTC GGT TGC CAA TAT CAA 39) and reverse primer B5 (59 CGC GCT TGC CTT TCA GGT CTG 39) [ 15 ]. The PCR cycling conditions were 30 cycles of denaturation at 95°C for 30 sec, annealing at 54°C for 90 sec, extension at 72°C for 90 sec, and followed by a final extension at 72°C for 6 min. The PCR products were electrophoresed on 1.5% agarose to detect specific bands at 223-bp.\nSamples from the uterus, cervix, and vagina of some selected cases based on histopathological observations were pooled. It was performed, according to Khans et al. [ 16 ]. Briefly, 2–3-day-old monolayer of Madin-Darby Bovine Kidney cell line, grown in flat-bottom 24-well tissue culture plates, was injected with 200 μl of the previously prepared supernatant per well. The plates were incubated for 1 h at 37ºC, and then, the inoculums were replaced with maintenance medium (Earle’s Minimum Essential Medium supplemented with 2% fetal calf serum) and incubated under standard culture condition (37ºC, 5% CO 2  and 85% humidity). The cells were checked for cytopathic effects (CPEs) using an inverted epifluorescence phase-contrast trinuclear microscope with a 20× plan chromatic lens daily for the next 5–7 days.\nDNA extraction: from the third passage of inoculated samples on MDBK cells, DNA was extracted from 200 μl of cellular suspension using QIAamp viral nucleic acid extraction kit (Qiagen, Valencia, CA) according to manufacturer’s protocol. The extracted DNA was eluted in the 60 μl of elution buffer and then stored at −20°C until used for PCR assay. PCR and agarose gel electrophoresis: the sets of primers were used to amplify separate BHV-2 genes. One set [primers 4109 (5′-GCG GCG GCG GAG TCT GGC TTT GAG-3′) and 4110 (5′-TCG CTG ATG TTG TTC GGA GGG AGG TTG A-3′)] was designed to amplify a 422-bp segment of the UL29 gene, which encodes the major DNA binding protein. Reactions were run as follows: pre-denaturation at 94°C for 3 min, followed by 40 cycles at 94°C for 30 sec, 68°C for 1 minute, and 72°C for 30 sec, and a final extension at 72°C for 7 min [ 17 ].\n\nExamination of 500 non-pregnant she-camels for uterine, cervical, and vaginal disorders revealed pathological lesions in 152 uteri (30.4%), 24 cervices (4.8%), and 20 vaginae (4%). The prevalence and characterization of those pathological abnormalities are shown in  Table 1 .\nThe observed pathologies were more pronounced in the summer than the other seasons of the year, followed by autumn, whereas the least number of abnormalities was observed in spring, as shown in  Figure 1A .\nUterine lesions constituted 30.4% of the total collected samples; 23.8% of them were classified as inflammatory lesions, and 11.6% were considered as non-inflammatory lesions.\nThe inflammatory lesions were observed in 119 cases; endometritis constituted the highest prevalence (18.8%) among the inflammatory lesions, followed by metritis (3%), perimetritis (1%), endomyometritis (0.6%), and finally, pyometra (0.4%).\nEndometritis was observed in 94 cases (18.8%). It was classified according to their duration and the predominant type of exudate into the following types.\nAcute catarrhal endometritis was the only type of acute endometritis and was detected in 33 cases (18.8%) during histopathological examination. Grossly, the endometrium was congested and edematous enlarged. Microscopically, the affected uteri showed focal epithelial desquamation and variable degrees of mononuclear inflammatory cell infiltration, particularly subepithelial and periglandular with pyknosis of the glandular nuclei ( Fig. 1a ). Some cases showed an amorphous golden yellow pigment (lipofuscin) deposition among the glands. Vasculitis and perivasculitis were common; the blood vessels showed edema in their walls and focal hyalinization ( Fig. 1b ).\nSubacute endometritis was detected only in 15 cases (3%) and characterized by heavy proprial mononuclear inflammatory cell infiltration ( Fig. 1c ) and mild congestion, vasculitis, and perivasculitis.\nChronic endometritis: three varieties of chronic endometritis were observed during histopathological examination such as chronic granulomatous endometritis, chronic fibrosing endometritis, and chronic cystic endometritis. Chronic granulomatous endometritis was observed in nine cases (1.8%). Apart from the pallor appearance of the uterine mucosa, no clear, gross lesions were found. However, microscopic examination revealed granulomatous aggregations of lymphocytes and macrophages subepithelially ( Fig. 1d ) accompanied by focal cystic or atrophic changes in the uterine glands and mild-to-moderate periglandular fibrosis.\nChronic fibrosing endometritis (chronic degenerative endometritis) was detected in 30 cases (6%). The En showed focal necrosis and desquamation of the lining epithelium with proprial fibroplasia and heavy lymphoplasmacytic infiltration. The endometrial glands appeared as islets sequestered by periglandular fibroplasia and inflammatory cells ( Fig. 1e ), including mast cells, which stained positive with periodic acid Schiff stain ( Fig. 1f ). Some other glands appeared necrosed and showed fibrous replacement ( Fig. 2a and b ). Edema and hyalinization of the blood vessels’ walls and perivascular fibroplasia ( Fig. 2c ) were common findings.\nChronic cystic endometritis was diagnosed in seven cases (1.4%) and characterized microscopically by cystic dilatation of endometrial glands, which appeared lined by flattened epithelium sometimes contained eosinophilic material in their lumens ( Fig. 2d ). Periglandular fibroplasia and inflammatory cell infiltration were noticed.\nThe morphometrical analysis of the area percentage of fibrous tissue (based on Massons’ trichrome staining) in chronic fibrosing endometritis and chronic cystic endometritis ( Fig. 2e ) revealed 40% and 25% area percent of fibrous tissue in both types of endometritis, respectively, which were significantly higher ( p  < 0.05) than in normal uteri (15%).\nPyometra was observed only in two cases (0.4%). The affected uteri showed a large amount of yellowish pus of foul odor in the uterine luminae ( Fig. 2f ) with a closed cervix. Microscopically, the mucosal epithelium was markedly necrosed and desquamated cells accompanied by heavy proprial polymorphonuclear cells infiltration, edema, and severe vasculitis ( Fig. 2g ). The endometrial glands showed degenerative changes and intraluminal polymorphonuclear cell infiltration. The myometrium showed an inflammatory reaction, intermuscular edema, vasculitis, and sometimes minute foci of hemorrhages.\nEndomyometritis was diagnosed in three cases (0.6%); the lesion was confined to the endo­metrium and myometrium without the involvement of the perimetrium. It was characterized by massive inflammatory cell infiltration ( Fig. 2h ).\nMetritis was observed in 15 cases (3%), and it was only of acute type; the affected uteri showed only mucosal congestion. In general, it is characterized by variable degrees of focal to diffuse inflammatory cell infiltration in all uterine layers, including the Pr ( Fig. 3a ), accompanied by various degenerative and necrotic changes of the endometrial glands.\nPerimetritis was detected microscopically in five cases (1%). It was either multifocal or diffuse and was associated with myometritis in one case. The non-inflammatory lesions were observed in 58 cases (11.6%). Adenomyosis constituted the highest prevalence (6%), followed by brown pigmentation (3%), endometrial hyperplasia (1.4%), hydrometra (0.6%), and uterine congestion (0.6%).\nUterine congestion was observed in three cases (0.6%). Grossly, those uteri showed multifocal to coalescing or diffuse areas of congestion, accompanied by pinpoint foci of hemorrhages distributed along the endometrial mucosa and the serosal parts of the uterus. Uterine pigmentation was detected microscopically in 15 cases (3%) represented by the appearance of light brown pigment distributed either freely in the endometrial stroma or engulfed by large cells.\nEndometrial hyperplasia was observed in seven cases (1.4%) characterized by a significantly increased number of the endometrial glands and endometrial stroma, which appeared packed with glands (gland crowding), particularly in the deeper parts ( Fig. 3b ). The morphometrical analysis of the area percent of the endometrial glands about stroma showed that, in cases of endometrial hyperplasia, it was about 18%–21%, which is higher than that in the normal uteri (8%–10%). While in chronic fibrosing (degenerative) endometritis, the area percent of the endometrial glands was about 4%–5%, which is lower than that of normal uteri ( Fig. 3c ).\nAdenomyosis was diagnosed in 30 cases (6%) with no specific gross lesions. Histologically, two forms of uterine adenomyosis were detected; the infiltrative form ( Fig. 3d ), where the endometrial glands and stroma appeared extended in the My, is far beyond the junction between the endo­metrium and myometrium. The second form was characterized by islands or discrete clusters of the endometrial glands and stroma in the My with no communication with the En ( Fig. 3e ).\nHydrometra was observed in three cases (0.6%), and it was characterized by uterine distention with a large amount of yellow straw fluid ( Fig. 3f ). Microscopic examination revealed atrophy of the En, uterine glands, and My.\nCervical lesions were observed in 24 cases, represented 4.8% of the total collected samples. Inflammatory lesions were the most typical lesion that observed and constituted 4.2%, whereas the non-inflammatory lesions comprised only 0.6%.\nAcute cervicitis was detected in eleven cases (2.2%). It was classified into mucopurulent, hemorrhagic, and purulo-hemorrhagic cervicitis.\nMucopurulent cervicitis was diagnosed in seven cases (1.4%). Grossly, the cervical mucosa was covered with yellowish viscous pus or mucopurulent exudates with sometimes a few ulcers ( Fig. 3g ). Microscopically, the mucosal epithelium showed degeneration, focal desquamation, focal hyperplasia, and goblet cells metaplasia with the luminal presence of pus admixed with mucous exudates and subepithelial inflammatory cells infiltration ( Fig. 3h ).\nHemorrhagic cervicitis was observed in two cases (0.4%). The cervical mucosa was intensively red with variable foci of hemorrhages ( Fig. 4a ). Microscopical examination revealed necrosis and desquamation of the epithelial linings, vascular congestion, and proprial extravasating blood admixed with inflammatory cell infiltration ( Fig. 4b ).\nPurulo-hemorrhagic cervicitis was diagnosed in two cases (0.4%), in which the mucosa was covered with viscous, yellowish purulent exudates under which the mucosa was studded with petechial and larger areas of hemorrhages ( Fig. 4c ). Microscopically, the cervical lumen showed the presence of free RBCs admixed with a large number of neutrophils with degeneration, necrosis, and focal desquamation of the cervical epithelium and heavy proprial infiltration by neutrophils, some lymphocytes and macrophages, free RBCs ( Fig. 4d ) as well as hemosiderin pigment granules which stained positive with Prussian blue. Mucosal cyst ( Fig. 4e ) was a conspicuous finding, appeared as subepithelial single or multiple variable sizes cystic spaces, lined by flattened epithelium with sometimes luminal homogenous eosinophilic fluid.\nChronic granulomatous cervicitis was diagnosed in 10 cases (2%). It was characterized by the presence of cellular granuloma consisted of aggregations of lymphocytes, plasma cells, and macrophages either in a focal or diffuse manner, over which the cervical epithelium was focally eroded ( Fig. 4f ).\nThe non-inflammatory lesions were limited to hyperplastic and metaplastic reactions of the cervical epithelium and detected only on microscopic examination.\nThe hyperplastic reaction was observed in two cases (0.4%) and characterized by marked folding of the cervical mucosa into the lumen as variable-sized finger-like projections ( Fig. 4g ). In comparison, focal squamous metaplasia of the cervical epithelium was detected in one case (0.2%) ( Fig. 4h ).\nVaginal lesions were observed in 20 cases, with an incidence of 4%, and were limited to an inflammatory reaction. All cases of vaginitis were associated with cervicitis, and 16 of them were associated with endometritis or metritis or perimetritis or pyometra.\nAcute vaginitis was detected in seven cases (1.4%); it was characterized by vacuolation, desquamation, and focal hyperplasia of the mucosal epithelium with submucosal edema mononuclear inflammatory cell infiltration. The muscle layer revealed intermuscular edema with vacuolation and necrosis of the muscle fibers.\nChronic vaginitis was diagnosed in five cases (1%). Grossly, mucosal ulceration was observed. Microscopically, focal epithelial necrosis and desquamation, with massive lymphoplasmacytic infiltration, were characteristic findings.\nChronic granulomatous vaginitis was detected in eight cases (1.6%). Grossly, it was characterized by the thickening of vaginal walls and microscopically by the presence of multiple cellular granulomas of lymphocytes, macrophages, and plasma cells ( Fig. 4i ). The mucosal epithelium over those granulomas was necrotic and eroded ( Fig. 4j ).\nThe samples which were sent for microbiological examination were only for those showed pathological abnormalities (196 specimens); it was found that 160 specimens (81.6%) were positive for bacterial isolation. As shown in  Table 2 , The total microbial recovery rate from she-camel’s uteri was 23.6%, and the most prevalent isolated organisms were  Escherichia coli  (16.4%),  Enterobacter cloacae  (12.8%), followed by  Klebsiella pneumoniae  (4.2%) and  S. aureus  (2.8%), whereas the least prevalence was for  Pseudomonas aeruginosa  (0.6%) and  Streptococcus pyogenes  (0.4%), in addition to  C. albicans  (0.4%). The isolated organisms were represented either as single or mixed infections ( Table 2 ). At the same time, the total microbial recovery rate from the cervix and vagina was 4.2% and 4%, respectively. The most prevalent isolated bacteria from the cervix were  S. aureus  (2.4%) followed by  K. pneumoniae  (1.2%),  P. aeruginosa  (0.8%), and finally  E. cloacae  (0.2) and  C. albicans  (1.4%) as well, whereas the most prevalent isolated bacteria from the vagina was  E. cloacae  (1.8%), followed by  E. coli  (2%),  S. aureus  (1.2%),  E. cloacae  (1%), and  K. pneumoniae  (0.4%) in addition to  C. albicans  (1%). The frequency of isolation of each organism either as a single or mixed infection with the corresponding pathological lesions is further shown in  Table 2 .\nOn the basis of histopathological findings, five samples were subjected to the detection of the herpes virus; two samples out of five pooled samples showed positive CPE on MDBK cell line. The PCR assay for the detection of Bovine herpes virus type 1 revealed that the expected 422-bp PCR fragment was successfully amplified in 2 CPE-positive samples ( Fig. 5 ).\n\nThe genital system disorders and their incidence should be allocated to reduce economic losses due to infertility problems and disorders of the genital organs, and their incidence must be allocated. In the current work, we investigated the genital of 500 she-camels that revealed pathological lesions in 152 uteri (30.4%), 24 cervices (4.8%), and 20 vaginae (4%). Various uterine disorders have been mentioned to be incorporated in reduced fertility in camelids [ 6 ]. The detected prevalence of uterine disorders (30.4%) was higher than that recorded by Shawky et al. [ 18 ], who found that uterine affection constituted 13.2%. The uterine changes in this work were classified into inflammatory and non-inflammatory lesions. The inflammatory lesions included subacute endometritis, acute catarrhal endometritis, chronic granulomatous endometritis, chronic fibrosing endometritis, chronic cystic endometritis, endomyometritis, metritis, perimetritis, and pyometra. In general, endometritis is of significant concern that can interfere with the animal reproductive efficacy, resulting in infertility, dropped production, and economic losses [ 19 ].\nAcute catarrhal endometritis was the most common uterine inflammatory condition (6.6%), a result which was almost identical to the one cited by Shawky et al. [ 18 ], who recorded it in 6.4% in Egypt. Meanwhile, it was higher than that obtained in Southeast Algeria (2.7%) [ 20 ].  E. coli, E. cloacae ,  S. aureus , mixed infection with  E. coli  and  E. cloacae,  and mixed infection of  E. cloacae  and  K. pneumoniae  were isolated from those cases in the current results, which come in a partial agreement with Nabih and Osman [ 21 ] who isolated  S. aureus, E .coli, Corynebacterium spp,  and  Salmonella spp.  in cases of catarrhal endometritis, whereas subacute endometritis was observed in this study in a percent of 3%, which disagrees with that mentioned by Nourani et al. [ 22 ] who diagnosed subacute endometritis in a percent of 8.3%.  E. cloacae ,  P. aeruginosa, E. coli,  and mixed infection of  E. coli  and  E. cloacae  were isolated from the cases of subacute endometritis. The results denoted that the incidence of granulomatous endometritis was about 1.8%.\nA higher incidence (3.6%) was recorded among the imported she-camels from Sudan [ 23 ].  Staphylococcus aureus ,  C. albicans,  and  E. coli  were isolated from those cases, a result of which was disagreed with that recorded by Hegazy et al. [ 23 ], who isolated  S. epidermidis  and  Corynebacterium pyogenes  from similar lesions. However, fungal infection was found to be a cause of granulomatous endometritis [ 24 ]. Chronic fibrosing (degenerative) endometritis was detected in 30 cases (6%). It was previously aforementioned in she-camel [ 3 ]. The degenerative changes observed during histopathological examination of these cases are mainly due to the extended periglandular and perivascular fibrosis.  E. coli ,  E. cloacae ,  K. \n pneumoniae ,  C. albicans , mixed  E. coli ,  E. cloacae,  and  K. pneumoniae , mixed infection of  E. coli  and  E. cloacae,  and mixed infection of  S. aureus  and  E. cloacae  were isolated from those cases. Regarding chronic cystic endometritis, it was observed in a percent of 1.4%, which is parallel to the results of Shawky et al. [ 18 ]. It was characterized by cystic dilatation of the endometrial glands with periglandular fibrosis. Glandular fibrosis may reduce the fertility of she-camels due to the loss of the secretory activity of such glands, which produce an unfavorable site for implantation.  E. coli  was the predominant isolate from cases with chronic cystic endometritis. In a previous study,  Micrococcus luteus ,  E. coli ,  Proteus  species, and  Citrobacter  were isolated from cases with chronic cystic catarrhal endometritis [ 25 ].\nThe current study revealed a low prevalence of cases with pyometra (0.4%) that is lower than that 1.1% mentioned by Benaissa et al. [ 20 ] in southeast Algeria.  Staphylococcus aureus, S. pyogenes,  and  P. aeruginosa  were incriminated in that condition.\nThree cases (0.6%) with endomyometritis were detected in this study, from which  E. coli  was isolated. Hence, the prevalence of metritis was 3%, which is nearly similar to that reported by Benaissa et al. (2.8%) [ 20 ].  E. coli ,  K. pneumoniae , mixed  E. coli  and  K. pneumoniae,  and mixed  E. coli  and  E. cloacae  were isolated from the cases of metritis. On the other hand, perimetritis was detected in five cases (1%), from which  E. coli  was isolated. In camels, the penis penetrates the cervical canal deep into the uterine cavity during mating [ 26 ]. Consequently, uterine inflammatory reaction could be initiated as a result of repeated erroneous mating, which induces a sort of repeated harm to the uterus with a subsequent inability to resist infection [ 27 ]. In addition, as  Camelidae  are induced ovulators, severe uterine inflammation could be a result of mating in an aggressive way during the wrong phase of the follicular development [ 3 , 26 ]. Uterine resistance to infection and its self-clearance capability from microorganisms is known to be reduced in the presence of degenerative endometrial changes or heavy infection repetition with pathogenic strains [ 28 , 29 ]. Postpartum complications, overbreeding, and unsanitary gynecological manipulation are major factors participating in uterine infection [ 29 ]. Regarding the non-inflammatory lesions of the uterus, adenomyosis constituted the highest incidence (6%), followed by uterine pigmentation (3%), cystic endometrial hyperplasia (1.4%), and then hydrometra and uterine congestion each represented 0.6%. The observed prevalence (6%) of adenomyosis was higher than that reported in Iran (3.75%) by Wajid [ 30 ]. It was either alone or associated with an inflammatory lesion, but the prevalence of them was numerically higher in animals with endometritis, which was similarly reported in cows [ 31 ]. Adenomyosis could be an endometrial stroma hyperplastic overgrowth or malformation, and it is common in all species [ 32 ]. It is noteworthy that no bacteria were isolated from cases of adenomyosis except when associated with an inflammatory condition, which agreed with Hegazy et al. [ 23 ]. Moreover, excessive estrogenic stimulation was reported to be an inducer for endometrial hyperplasia, hydrometra, and mucometra [ 33 ]. The later excessive estrogen could originate either from an endogenous source such as granulosa cell tumors and follicular cysts or from exogenous sources such as clover pastures containing estrogenic compounds and synthetic estrogens used for remedy purposes [ 34 ].\nUterine pigmentation was identified microscopically in 15 cases and was referred to lipofuscin. It was negative for hemosiderin when stained with Perl’s Prussian blue stain. Lipofuscins were commonly known as wear-and-tear pigments or age pigments [ 35 ], and most domestic ruminants were reported to have uterine lipofuscins [ 36 ]. Regarding cervicitis, it was generally associated with uterine infection, which supported the views of some authors that infectious agents in the vagina move to the cervix and then to the uterine lumen and could lead to cervicitis and endometritis [ 37 ]. In the current study, 21 cases of cervicitis were observed (4.2%), which is considered a higher percentage than that observed by Shawky et al. (0.4%) [ 18 ].\nThe non-inflammatory lesions of the cervix were limited to hyperplastic (0.4%) and metaplastic (0.2%) changes of the cervical epithelium that was mostly accompanied by the inflammatory reaction. In light of these findings, metaplasia and hyperplasia might be attributed to chronic inflammatory reactions.\nThe observed vaginal changes were of low incidence represented by vaginitis (4%). This low incidence could be attributed to two factors; the first is the protective effect exerted by the vaginal mucosal stratified squamous epithelial lining, which is known to proliferate and mature under the estrogen influence and to be more resistant to infection, whereas the second is due to local production of lactic acid by normal resident  Lactobacillus  bacteria in the vagina which deposits into the epithelium [ 38 ]. In general, the cause of this vaginal affection is usually traumatic during coitus, particularly in young females [ 9 ]. Vaginitis (4%) was the only vaginal disorder observed in the current work, in which prevalence is higher than that reported by Shawky et al. (0.6%) [ 18 ]. An inflamed vagina may have resulted from inadequate hygienic conditions during parturition, postpartum, and vaginal examinations. Bacteriological isolation revealed that  E. coli ,  E. cloacae ,  K. pneumoniae,  and  S. aureus  were incriminated in cases of vaginitis, whereas  S. pyogenes  (31%),  E. coli  (24%), and  S. aureus  (20%) were the most common bacterial pathogens isolated from the vagina of camels with vaginitis in Nigeria [ 39 ].\nTwo cases of vaginitis were positive for Herpesvirus isolation, which agreed with the results of Darwish et al. [ 40 ]. As all  Herpesviridae , BHV-1 remains latent in infected animals and may recur under certain stress conditions, and shedding of the virus may or may not be accompanied by clinical signs [ 41 ]. Since a normal criterion of BHV-1 infection is the viral latency, it is very important to identify the apparently healthy serologically positive animals, where this provides a reliable and useful indicator for the infection status [ 42 ]. Any animal with antibodies to the virus is considered to be a carrier and potential intermittent excretory of the virus. The only exceptions are calves that have acquired passive colostral antibodies from their dam and vaccination [45]. In general, the microbiological examination of she-camel uteri with pathological lesions revealed that the most prevalent isolated organisms were  E. coli ,  E. cloacae, S. aureus,  and  K. pneumoniae,  whereas the least prevalence was  P. aeruginosa, S. pyogenes,  and  C. albicans . These microorganisms are known to be substantial causes of uterine, cervical, and vaginal disorders in these livestock species. Such results are of high significance since the isolated organism has zoonotic importance and can be occupationally transmitted to human during handling with those affected she-camels.\n\nThe incidence of uterine, cervical, and vaginal pathologic lesions in camels slaughtered in three abattoirs in Giza, Egypt, from January 2016 to January 2018 was 30.4%, 4.8%, and 4%, respectively. Endometritis was the major reproductive problem recorded in the examined organs, and six bacterial species were incorporated in such a problem, including  E. coli ,  E. cloacae ,  S. aureus ,  K. pneumoniae ,  P. aeruginosa,  and  C. albicans,  with the highest prevalence for  E. coli  and  S. aureus.  The role of each reproductive problem in inducing reproductive failure in such camel species needs further investigation. Female animals should be routinely microbiologically evaluated against uterine disorders, particularly before breeding seasons. This practice, coupled with appropriate antibiosis, will enhance the reproductive efficiencies of this livestock species. Moreover, good hygienic practice during handling of the affected camel should be applied to avoid the zoonotic transmission of such pathogens. Finally, the current investigation shows that the reproductive pathology and diseases in dromedary camels are more prevalent than initially assumed. Therefore, further research should be conducted to ascertain their clinical aspects and their role as causes of reproductive defects in these animals.","source_license":"CC-BY-4.0","license_restricted":false}