Cervicitis diagnostic study of choice: Difference between revisions
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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 [[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> | *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 [[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]]. | *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]]. | ||
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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
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]
- Abnormal vaginal bleeding:
- 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.