Cervix

Acute Cervicitis

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Acute Cervicitis, Cervicitis, Mucopurulent Cervicitis, Mucopurulent Vaginitis

  • 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
  • Causes
  • Non-Infectious
  1. Irritant Vaginitis (e.g. frequent douching)
  2. Trauma
  3. Radiation
  4. Malignancy
  • Signs
  1. See Pelvic Inflammatory Disease
  2. See Vaginitis
  3. See Sexually Transmitted Infection
  4. Pustular cervical discharge
  • 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
  • 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
  • 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
  • References