Cervicitis diagnostic study of choice: Difference between revisions
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== Overview == | == Overview == | ||
There is no single [[diagnostic]] study of choice for the [[diagnosis]] of cervicitis. There are two major diagnostic signs that characterize cervicitis, Purulent or [[mucopurulent]] endocervical [[exudate]] visible in the [[endocervical canal]] or on an endocervical [[swab]] [[specimen]] (commonly referred to as [[mucopurulent]] cervicitis) and sustained [[endocervical]] [[bleeding]] is easily induced by gentle passage of a cotton swab through the [[cervical]] os. Cervicitis is usually [[asymptomatic]], [[symptoms]] observed include, [[abnormal]] [[vaginal discharge]], and/or intermenstrual [[vaginal]] [[bleeding]] (e.g., especially after sexual intercourse). | |||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
=== Study of choice === | === Study of choice === | ||
There is no single [[diagnostic]] study of choice for the [[diagnosis]] of cervicitis. | There is no single [[diagnostic]] study of choice for the [[diagnosis]] of cervicitis. | ||
*There are two major diagnostic signs that characterize cervicitis: | *There are two major diagnostic signs that characterize cervicitis<ref name="pmid16453256">{{cite journal| author=Marrazzo JM, Wiesenfeld HC, Murray PJ, Busse B, Meyn L, Krohn M et al.| title=Risk factors for cervicitis among women with bacterial vaginosis. | journal=J Infect Dis | year= 2006 | volume= 193 | issue= 5 | pages= 617-24 | pmid=16453256 | doi=10.1086/500149 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16453256 }} </ref><ref name="pmid2921049">Dunlop EM, Garner A, Darougar S, Treharne JD, Woodland RM (1989) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2921049 Colposcopy, biopsy, and cytology results in women with chlamydial cervicitis.] ''Genitourin Med'' 65 (1):22-31. PMID: [https://pubmed.gov/2921049 2921049]</ref> | ||
**Purulent or [[mucopurulent]] endocervical [[exudate]] visible in the [[endocervical canal]] or on an endocervical [[swab]] [[specimen]] (commonly referred to as [[mucopurulent]] cervicitis) | **Purulent or [[mucopurulent]] endocervical [[exudate]] visible in the [[endocervical canal]] or on an endocervical [[swab]] [[specimen]] (commonly referred to as [[mucopurulent]] cervicitis) | ||
**Sustained [[endocervical]] [[bleeding]] is easily induced by gentle passage of a cotton swab through the [[cervical]] os. | **Sustained [[endocervical]] [[bleeding]] is easily induced by gentle passage of a cotton swab through the [[cervical]] os. | ||
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**[[Abnormal]] [[vaginal discharge]] | **[[Abnormal]] [[vaginal discharge]] | ||
**Intermenstrual [[vaginal]] [[bleeding]] (e.g., especially after sexual intercourse) | **Intermenstrual [[vaginal]] [[bleeding]] (e.g., especially after sexual intercourse) | ||
*Increased number of WBCs on endocervical | *Increased number of WBCs on endocervical [[gram stain]] in the [[diagnosis]] of cervicitis has not been standardized; it is not sensitive, has a low [[positive predictive value]] for [[C. trachomatis]] and [[N. gonorrhea]] [[infections]], and is not available in most clinical settings.<ref name="pmid6896368">{{cite journal| author=McLellan R, Spence MR, Brockman M, Raffel L, Smith JL| title=The clinical diagnosis of trichomoniasis. | journal=Obstet Gynecol | year= 1982 | volume= 60 | issue= 1 | pages= 30-4 | pmid=6896368 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6896368 }} </ref> | ||
*[[Leukorrhea]], defined as >10 WBCs/HPF on [[microscopic]] [[examination]] of [[vaginal fluid]], might be a sensitive indicator of cervical inflammation with a high negative predictive value (i.e., cervicitis is unlikely in the absence of leukorrhea). | *[[Leukorrhea]], defined as >10 WBCs/HPF on [[microscopic]] [[examination]] of [[vaginal fluid]], might be a sensitive indicator of [[cervical]] [[inflammation]] with a high [[negative predictive value]] (i.e., cervicitis is unlikely in the absence of [[leukorrhea]]). | ||
*Presence of gram-negative [[intracellular]] [[diplococci]] on | *Presence of [[gram-negative]] [[intracellular]] [[diplococci]] on [[gram stain]] of [[endocervical]] [[exudate]] might be specific for diagnosing gonococcal [[cervical]] [[infection]] when evaluated by an experienced laboratorian, it is not a sensitive indicator of [[infection]]. | ||
==References== | ==References== | ||
Latest revision as of 16:11, 7 October 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]
Overview
There is no single diagnostic study of choice for the diagnosis of cervicitis. There are two major diagnostic signs that characterize cervicitis, Purulent or mucopurulent endocervical exudate visible in the endocervical canal or on an endocervical swab specimen (commonly referred to as mucopurulent cervicitis) and sustained endocervical bleeding is easily induced by gentle passage of a cotton swab through the cervical os. Cervicitis is usually asymptomatic, symptoms observed include, abnormal vaginal discharge, and/or intermenstrual vaginal bleeding (e.g., especially after sexual intercourse).
Diagnostic Study of Choice
Study of choice
There is no single diagnostic study of choice for the diagnosis of cervicitis.
- There are two major diagnostic signs that characterize cervicitis[1][2]
- Purulent or mucopurulent endocervical exudate visible in the endocervical canal or on an endocervical swab specimen (commonly referred to as mucopurulent cervicitis)
- Sustained endocervical bleeding is easily induced by gentle passage of a cotton swab through the cervical os.
- Cervicitis is usually asymptomatic, symptoms observed include:[3][4]
- Abnormal vaginal discharge
- Intermenstrual vaginal bleeding (e.g., especially after sexual intercourse)
- Increased number of WBCs on endocervical gram stain in the diagnosis of cervicitis has not been standardized; it is not sensitive, has a low positive predictive value for C. trachomatis and N. gonorrhea infections, and is not available in most clinical settings.[5]
- Leukorrhea, defined as >10 WBCs/HPF on microscopic examination of vaginal fluid, might be a sensitive indicator of cervical inflammation with a high negative predictive value (i.e., cervicitis is unlikely in the absence of leukorrhea).
- Presence of gram-negative intracellular diplococci on gram stain of endocervical exudate might be specific for diagnosing gonococcal cervical infection when evaluated by an experienced laboratorian, it is not a sensitive indicator of infection.
References
- ↑ Marrazzo JM, Wiesenfeld HC, Murray PJ, Busse B, Meyn L, Krohn M; et al. (2006). "Risk factors for cervicitis among women with bacterial vaginosis". J Infect Dis. 193 (5): 617–24. doi:10.1086/500149. PMID 16453256.
- ↑ Dunlop EM, Garner A, Darougar S, Treharne JD, Woodland RM (1989) Colposcopy, biopsy, and cytology results in women with chlamydial cervicitis. Genitourin Med 65 (1):22-31. PMID: 2921049
- ↑ Holló P, Jókai H, Herszényi K, Kárpáti S (2015). "[Genitourethral infections caused by D-K serotypes of Chlamydia trachomatis]". Orv Hetil. 156 (1): 19–23. doi:10.1556/OH.2015.30078. PMID 25544050.
- ↑ Barlow D, Phillips I (1978). "Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects". Lancet. 1 (8067): 761–4. PMID 76760.
- ↑ McLellan R, Spence MR, Brockman M, Raffel L, Smith JL (1982). "The clinical diagnosis of trichomoniasis". Obstet Gynecol. 60 (1): 30–4. PMID 6896368.