Cervicitis

Cervicitis
Classification and external resources
Specialty urology
ICD-10 N72
ICD-9-CM 098.15, 099.53, 616.0
DiseasesDB 30734
MedlinePlus 001495
eMedicine med/323
MeSH D002575

Cervicitis is inflammation of the uterine cervix. Cervicitis in women has many features in common with urethritis in men and many cases are caused by sexually transmitted infections. Death may occur.[1][2] Non-infectious causes of cervicitis can include intrauterine devices, contraceptive diaphragms, and allergic reactions to spermicides or latex condoms.[3] The condition is often confused with vaginismus which is a much simpler condition and easily rectified with simple exercises.

Causes

Cervicitis can be caused by any of a number of infections, of which the most common are chlamydia and gonorrhea, with chlamydia accounting for approximately 40% of cases.[4] As many half of pregnant women are asymptomatic with a gonorrhea infection of the cervix.[5] Trichomonas vaginalis and herpes simplex are less common causes of cervicitis. There is a consistent association of M. genitalium infection and female reproductive tract syndromes. M. genitalium infection is significantly associated with increased risk of cervicitis.[6]

Mucopurulent cervicitis

Mucopurulent cervicitis (MPC) is characterized by a purulent or mucopurulent endocervical exudate visible in the endocervical canal or in an endocervical swab specimen. Some specialists also diagnose MPC on the basis of easily induced cervical bleeding. Although some specialists consider an increased number of polymorphonuclear white blood cells on endocervical Gram stain as being useful in the diagnosis of MPC, this criterion has not been standardized, has a low positive-predictive value (PPV), and is not available in some settings. MPC often is without symptoms, but some women have an abnormal vaginal discharge and vaginal bleeding (e.g., after sexual intercourse). MPC can be caused by Chlamydia trachomatis or Neisseria gonorrhoeae; however, in most cases neither organism can be isolated.[2] MPC can persist despite repeated courses of antimicrobial therapy. Because relapse or reinfection with C. trachomatis or N. gonorrhoeae usually does not occur in persons with persistent cases of MPC, other non-microbiologic determinants (e.g., inflammation in the zone of ectopy) might be involved.

Patients who have MPC should be tested for C. trachomatis and for N. gonorrhoeae with the most sensitive and specific test available. However, MPC is not a sensitive predictor of infection with these organisms; most women who have C. trachomatis or N. gonorrhoeae do not have MPC.

References

  1. Workowski KA, Berman SM (August 2006). "Sexually transmitted diseases treatment guidelines, 2006". MMWR Recomm Rep. 55 (RR–11): 1–94. PMID 16888612.
  2. 1 2 Hynes NA (2008-10-30). "hopkins-abxguide.org". Point-of-care Information Technology. Johns Hopkins University. Retrieved 2010-02-03.
  3. MedlinePlus Encyclopedia Cervicitis
  4. Mitchell, Richard Sheppard; Kumar, Vinay; Robbins, Stanley L.; Abbas, Abul K.; Fausto, Nelson (2007). Robbins basic pathology (8th ed.). Saunders/Elsevier. pp. 716–8. ISBN 1-4160-2973-7.
  5. Kenner, Carole (2014). Comprehensive neonatal nursing care (5th ed.). New York, NY: Springer Publishing Company, LLC. ISBN 9780826109750. Access provided by the University of Pittsburgh.
  6. Lis, R.; Rowhani-Rahbar, A.; Manhart, L. E. (2015). "Mycoplasma genitalium Infection and Female Reproductive Tract Disease: A Meta-Analysis". Clinical Infectious Diseases. 61: 418–26. doi:10.1093/cid/civ312. ISSN 1058-4838. PMID 25900174.
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