Cervicitis

Introduction

• Description: Cervicitis is the inflammation (acute or chronic) of the endocervical glands or the ectocervix. Less commonly it can affect the squamous epithelium of the ectocervix.

• Prevalence: 10%–40% of women.

• Predominant Age: Reproductive age; highest rate in adolescents to early 20s.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Endocervical— Chlamydia trachomatis (up to 60% of cases in some studies), Neisseria gonorrhoeae. Almost 50% of patients will not have an identifiable infection. Ectocervical—herpes simplex, human papillomavirus (HPV), Mycoplasma species ( Mycoplasma hominis, Ureaplasma urealyticum ), Trichomonas vaginalis.

• Risk Factors: Exposure to sexually transmitted infections (STIs; multiple sexual partners), postpartum period.

Signs and Symptoms

• May be asymptomatic (60%)

• Mucopurulent discharge (yellow discharge with ≥10 white blood cells at magnification ×1000)

• Cervical erythema or edema, ulceration, and friability

• Deep-thrust dyspareunia

• Postcoital or intermenstrual bleeding

• Urinary tract infection and dysuria may occur

Diagnostic Approach