Cervicitis

Chapter 105 Cervicitis



INTRODUCTION



Description: Cervicitis is inflammation (acute or chronic) of the endocervical glands or the ectocervix.

Prevalence: Ten percent to 40% of women.

Predominant Age: Reproductive, greatest rate in adolescents to early 20s.

Genetics: No genetic pattern.


ETIOLOGY AND PATHOGENESIS



Causes: Endocervical—Chlamydia trachomatis (up to 60% of cases in some studies), Neisseria gonorrhoeae. (Almost 50% of patients will not have an identifiable infection.) Ectocervical—herpes simplex, human papillomavirus (HPV), Mycoplasma species (Mycoplasma hominis, Ureaplasma urealyticum), Trichomonas vaginalis.

Risk Factors: Exposure to sexually transmitted infections (multiple sexual partners), postpartum period.


CLINICAL CHARACTERISTICS



Signs and Symptoms



May be asymptomatic (60%)

Mucopurulent discharge (yellow discharge with 10 or more white blood cells at magnification ×1000)

Cervical erythema or edema, ulceration, and friability

Deep-thrust dyspareunia


DIAGNOSTIC APPROACH



Differential Diagnosis



• Vaginitis

• Cervical neoplasia

• Cervical metaplasia

• Cervical erosion

• Cervical eversion


Associated Conditions: Cervical neoplasia, dyspareunia, postcoital bleeding, pelvic inflammatory disease, premature rupture of the membranes in pregnancy, premature labor, and prematurity.


Workup and Evaluation



Laboratory: Cervical culture, Gram stain of cervical material, enzyme-linked immunosorbent assay (ELISA) or fluorescent monoclonal antibody testing for Chlamydia. Consider serum testing for other sexually transmitted infections.

Imaging: No imaging indicated.

Special Tests: None indicated.

Diagnostic Procedures: Inspection, Gram stain, culture, ELISA, or fluorescent monoclonal antibody testing. Colposcopy may be of assistance in selected cases. Nucleic acid activation tests are rapidly becoming the method of choice for detecting C. trachomatis or N. gonorrhoeae.


Pathologic Findings

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Cervicitis

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