Cervicitis diagnostic study of choice
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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:
- 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:
- 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.
- 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