Acute Cervicitis

Aka: Acute Cervicitis, Cervicitis, Mucopurulent Cervicitis, Mucopurulent Vaginitis

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II. Causes: Infection (esp. Mucopurulent Cervicitis)

  1. Neisseria gonorrhoeae
  2. Trichomonas vaginalis
  3. Genital Herpes Simplex Virus (HSV II)
  4. Human Papilloma virus
  5. Chlamydia trachomatis
  6. Mycoplasma Genitalium

III. Causes: Non-Infectious

  1. Irritant Vaginitis (e.g. frequent douching)
  2. Trauma
  3. Radiation
  4. Malignancy

IV. Signs

  1. See Pelvic Inflammatory Disease
  2. See Vaginitis
  3. See Sexually Transmitted Infection
  4. Pustular cervical discharge

V. Diagnosis: Mucopurulent cervical discharge

  1. Mucopurulent endocervical discharge
  2. Cervical friability with insertion of a cotton swab into endocervical canal
  3. Wet Prep with >10 White Blood Cells per high powered field

VI. Labs

  1. Gonorrhea PCR
  2. Chlamydia PCR
  3. Wet Preparation
    1. Trichomonas Vaginalis (PCR testing is also available)
    2. Bacterial Vaginosis
  4. Other testing
    1. HIV Test (recommended in all patients with STI)
    2. Consider RPR for Syphilis
    3. Swab lesions for HSV if suspected

VII. Management

  1. See Pelvic Inflammatory Disease
  2. See Vaginitis
  3. See Sexually Transmitted Infection
  4. See Endometritis Management
  5. Empirically treat for Chlamydia and Gonorrhea while awaiting testing
  6. Consider resistant Mycoplasma Genitalium in refractory cases

VIII. References

  1. (2018) Sanford Guide, accessed on IOS, 9/20/2019
  2. (2015) MMWR 64(RR3):1-137 [PubMed]
    1. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6403a1.htm

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