Cervicitis overview
|
Cervicitis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Cervicitis overview On the Web |
|
American Roentgen Ray Society Images of Cervicitis overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Cervicitis means nflammation of the tissues of the cervix. Cervicitis has many features in common with urethritis in men. These are commonly due to sexually transmitted infections.
Historical Perspective
Cervicitis was first described formally by Dr. Voilet I. Russell and Dr. D. Cochrane Logan in 1926 during their addresses made before the Medical Society for the Study of Veneral Diseases on 29th January 1926. Before this time, no accurate record was made about the disease in literature.[1]
Classification
Cervicitis may be classified according to the etiology, anatomical location and disease duration as infectious, non-infectious, acute, subacute and chronic cervicitis. The infectious causes are Gonococcal, C. trachomatis and Herpes. Examples of the non-infectious causes are traumatic injury to the cervix, chemical exposure; douching, latex, contraceptive creams, systemic inflammation example Behcet syndrome as well as radiation exposure.
Pathophysiology
The pathophysiology of Cervicitis depends on the etiological agent and the physiological state of the patient. Under the influence of estrogen, the normal vaginal epithelium cornifies making it somewhat resistant to infectious agents. The endocervix is lined by columnar epithelium which is susceptible to infectious agents leading to cervicitis.
Gonococcal cervicitis results after the exposure of the cervix to N. gonorrhea in seminal fluid during sexual intercourse. N. gonorrhea infectivity is facilitated by type IV pilus-mediated motility of the bacterium. In the presence of seminal fluid, the bacterial motility is characterized by high velocity, low directional persistence and enhanced microcolony formation.[2] Once pilus is attached, local inflammation results from release of neutrophilic cytokines leading to purulent or mucopurulent discharge. C. trachomatis infection is often associated with intense lymphocytic and neutrophilic inflammtory reaction in the affected areas and occasionally with follicular aggregation of lymphocyte.[3][4] The chronic course of chlamydial cervicitis is associated with low content of cytokines mainly IL-1 alpha, IL-1 beta, TNF-alpha and an elevated concentration of IL-8 in the pathogenesis.[5]
Causes
Cervicitis is caused by infectious [6][7][8][9][10][11][12][13][14][15] and non infectious causes. The infectious causes are most commonly caused by chlamydia and gonorrhea, with chlamydia accounting for the majority of cases. Trichomonas vaginalis and herpes simplex are less common causes of cervicitis. Non-infectious causes of cervicitis include: intrauterine devices, contraceptive diaphragms, and allergic reactions to spermicides or latex condoms
Differentiating Cervicitis overview from Other Diseases
Cervicitis must be differentiated from other diseases that cause vaginal discharge and/or pelvic pain, such as endometritis, salpingitis, vaginitis and vulvovaginatis.
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
History and Symptoms
Mucopurulent cervicitis often is asymptomatic, but some women have an abnormal vaginal discharge and vaginal bleeding (e.g., after sexual intercourse).
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Antibiotics are used to treat bacterial infections, such as chlamydia, gonorrhea, and others. Drugs called antivirals may be used to treat herpes infections. Hormonal therapy (with estrogen or progesterone) may be used in women who have reached menopause (postmenopausal). When these treatments have not worked or when cervicitis has been present for a long time, treatment may include cryosurgery (freezing), electrocauterization, or laser therapy.[16]
Surgery
Prevention
References
- ↑ Russell VI (1926). "DIAGNOSIS AND TREATMENT OF URETHRITIS AND CERVICITIS". Br J Vener Dis. 2 (6): 182–93. PMC 1046487. PMID 21772527.
- ↑ Anderson MT, Dewenter L, Maier B, Seifert HS (2014). "Seminal plasma initiates a Neisseria gonorrhoeae transmission state". MBio. 5 (2): e01004–13. doi:10.1128/mBio.01004-13. PMC 3958800. PMID 24595372.
- ↑ Paavonen J, Vesterinen E, Meyer B, Saksela E (1982). "Colposcopic and histologic findings in cervical chlamydial infection". Obstet Gynecol. 59 (6): 712–5. PMID 7078909.
- ↑ 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. PMC 1196182. PMID 2921049.
- ↑ Dolgushin II, Kurnosenko IV, Dolgushina VF, Ugaĭ IIu, Abramovskikh OS, Gol'tsfarb VM (2004). "[Clinical and immunological aspects of cervicitis of chlamydial etiology]". Zh Mikrobiol Epidemiol Immunobiol (3): 48–52. PMID 15346950.
- ↑ Lusk MJ, Garden FL, Rawlinson WD, Naing ZW, Cumming RG, Konecny P (2016). "Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics". Sex Transm Infect. 92 (3): 175–81. doi:10.1136/sextrans-2015-052332. PMID 26586777.
- ↑ Gaydos C, Maldeis NE, Hardick A, Hardick J, Quinn TC (2009). "Mycoplasma genitalium as a contributor to the multiple etiologies of cervicitis in women attending sexually transmitted disease clinics". Sex Transm Dis. 36 (10): 598–606. doi:10.1097/OLQ.0b013e3181b01948. PMC 2924808. PMID 19704398.
- ↑ Mobley VL, Hobbs MM, Lau K, Weinbaum BS, Getman DK, Seña AC (2012). "Mycoplasma genitalium infection in women attending a sexually transmitted infection clinic: diagnostic specimen type, coinfections, and predictors". Sex Transm Dis. 39 (9): 706–9. doi:10.1097/OLQ.0b013e318255de03. PMC 3428747. PMID 22902666.
- ↑ Ona S, Molina RL, Diouf K (2016). "Mycoplasma genitalium: An Overlooked Sexually Transmitted Pathogen in Women?". Infect Dis Obstet Gynecol. 2016: 4513089. doi:10.1155/2016/4513089. PMC 4860244. PMID 27212873.
- ↑ Lusk MJ, Konecny P (2008). "Cervicitis: a review". Curr Opin Infect Dis. 21 (1): 49–55. doi:10.1097/QCO.0b013e3282f3d988. PMID 18192786.
- ↑ Marrazzo JM, Martin DH (2007). "Management of women with cervicitis". Clin Infect Dis. 44 Suppl 3: S102–10. doi:10.1086/511423. PMID 17342663.
- ↑ Korte JE, Baseman JB, Cagle MP, Herrera C, Piper JM, Holden AE; et al. (2006). "Cervicitis and genitourinary symptoms in women culture positive for Mycoplasma genitalium". Am J Reprod Immunol. 55 (4): 265–75. doi:10.1111/j.1600-0897.2005.00359.x. PMID 16533338.
- ↑ Hezarjaribi HZ, Fakhar M, Shokri A, Teshnizi SH, Sadough A, Taghavi M (2015). "Trichomonas vaginalis infection among Iranian general population of women: a systematic review and meta-analysis". Parasitol Res. 114 (4): 1291–300. doi:10.1007/s00436-015-4393-3. PMID 25732256.
- ↑ Nugent RP, Hillier SL (1992). "Mucopurulent cervicitis as a predictor of chlamydial infection and adverse pregnancy outcome. The Investigators of the Johns Hopkins Study of Cervicitis and Adverse Pregnancy Outcome". Sex Transm Dis. 19 (4): 198–202. PMID 1411834.
- ↑ Eschenbach DA, Buchanan TM, Pollock HM, Forsyth PS, Alexander ER, Lin JS; et al. (1975). "Polymicrobial etiology of acute pelvic inflammatory disease". N Engl J Med. 293 (4): 166–71. doi:10.1056/NEJM197507242930403. PMID 806017.
- ↑ Diseases Characterized by Urethritis and Cervicitis. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/std/tg2015/urethritis-and-cervicitis.htm Accessed on July 28, 2016