cervicitis causes – definition – symptoms – treatment
Dr.Kut | Dec 30, 2009 | Comments 1
What is Cervicitis?
As the lower part of the woman’s uterus, cervix provides as an inlet and outlet which may harbor certain inflammatory conditions coined as Cervicitis. Cervicitis is defined as an inflammatory process of the cervix due to common infection that occurs either locally, sexual transmission, or other acquired conditons.
What are the causes of Cervicitis?
Cervix is often a potential reservoir for various sexually transmitted diseases such as Neisseria gonorrhea, Chlamydia trachomatis, herpes simplex virus, human papilloma virus and Mycoplasma species. These pathogens often cause inflammation and infection of the cervix causing cervicitis. Other cervicitis causes may include insertion of any foreign body into the cervix an example of which are birth control devices like cervical cap, diaphragm, and chemical agents.
Cervicitis Pathophysiology
Cervicitis is an inflammation of the cervix and normally an inflammation is our body’s normal responsive defense following injury, irritation, or infection. Moreover, white blood cells increases and mobilizes for which blood circulation increases causing a reddened and swollen appearance.
What are the symptoms of Cervicitis?
In most cases of mild or acute infection, an infected individual is often asymptomatic. However, the first initial symptom is vaginal discharge which may become unusually profuse following a menstruation. Other signs include vaginal bleeding, painful intercourse, vaginal pain, itching, burning sensation while urinating, vaginal spotting or bleeding after sexual intercourse and low back or vaginal pain during intercourse. During severe cases, a profuse puss-like, malodorous vaginal discharge may be noted accompanied by intense vaginal itchiness or pain. Systemic spread of infection could cause symptoms of fever, abdominal pain, nausea, and body pains.
What are the types of Cervicitis?
Cervicitis can be classified into Acute and Chronic. Acute cervicitis is usually of mild condition characterized with symptoms of irritated and reddish cervix and thick yellowish vaginal discharge. On other cases, the vaginal discharge may also appear white and gray in color accompanied by a distinct odor. Common pathogens leading to acute cervicitis are Neisseria gonorrhea, Chlamydia trachomatis, and Herpes virus. On the other hand, chronic cervicitis is usually a determined cause of repetitive episodes of acute cervicitis, or cases of untreated infected conditions. Symptoms may include unusual vaginal discharge with associated back and vaginal pain during sexual intercourse and discomfort in urination.
Who are at risk for Cervicitis?
Individuals who are at greatest risk are those who engaged on sexual intercourse at an early age especially to those who have high risk sexual practices such as multiple sexual partners. Those who are exposed to sexual transmitted diseases and various chemicals such as douches, contraceptives, and forgotten tampon could also be at risk for cervicitis because it may result to irritation brought by infection or allergies. People with debilitating disease such as diabetes mellitus have depressed immune systems and can acquire infection easily. Conditions such as acute or recurrent vaginitis make one prone for cervical irritation and injury causing cervicitiis as well.
How do you distinguish Follicular cervicitis versus Mucopurulent cervicitis?
Follicular cervicitis is known as a benign inflammatory condition of the cervix. It is semi-specific for chlamydial infection. Most of the time, follicular cervicitis is diagnosed by routine cervical pap smear and this disease is usually common among post menopausal women. When it comes to distinct diagnosis of active cervical infection, mucopurulent cervicitis is the suggested term used. To establish a diagnosis, two definitive objective criteria is used to characterize mucopurulent cervicitis – a) gross visualization of yellow mucopurulent material on white cotton swab and the presence of 10 or more polymorphonuclear leukocytes per microscopic field (magnification x 1000) on Gram-stained smears obtained from the endocervix. Other criterion includes erythema and edema, bleeding, ulceration, and friability when smear was obtained. In comparison, mucopurulent cervicitis is almost specific for various sexually transmitted diseases to include Chlamydia trachomatis, Neisseria gonorrhea, and in some cases of active herpes infection.
How do we diagnose cervicitis?
A thorough medical history and physical examination often marks up the diagnosis of cervicitis. The true evidence of the problem causing the symptoms is carefully investigated and then correlated to the physical examination usually after a visual inspection of the cervix and pap smear with cotton swab called “wet smear”. This is sent to the laboratory for further determination of the causative microorganism causing the symptoms. In cases when cervix appears abnormal, biopsy is done to rule out the possibility of cancer. Colposcopy is another diagnostic procedure used to have a magnified view of the cervix which also serves to determine cancer. A new diagnostic tool used is Cervicography, where in a doctor takes photographs of the cervix and then later on a specialist will interpret it and discuss the results with the doctor and the patient.
What are the treatments used for cervicitis?
Since sexually transmitted diseases are the most common cause of cervicitis, antibiotics are indicated as treatments. For Chlamydia trachomatis infection, a broad spectrum antibiotics are used such as doxicycline, azithromycin, ofloxacin, and erythromycin. The dosages of these drugs may range from 100 to 200 mg capsules and should be taken for an average of 4 to 7 days. Chlamydial type of infection should be treated aggressively due to risks of ascending infection affecting the fallopian tubes and uterus. When Neisseria gonorrhea is suspected, antibiotics like ceftriaxone, cefixime, ciprofloxacin, and ofloxacin are commonly utilized. In most cases, after treatment for neisseria infection, a broad spectrum of antibiotics indicated for Chlamydia is given as these diseases usually coexists. As for Trichomanas infection, Metronidazole is the drug of choice. On the other hand Zovirax is the drug used for herpes viral infection. Please be noted that these pathogens causing cervicitis when left untreated may result to sterility or infertility due to its affect on the surrounding reproductive structures. Routine follow-up check-ups with a Gynecologist is also advised especially for recurrent types and herpes virus infection since cervical cancer may be a risk for these individuals. In cases of chronic and recurrent cervicitis, other special procedures can also be used and this includes cautery, cryosurgery, and laser treatment.
REFERENCES:
Comprehensive Gynecology book by Laniel R. Mishell, Jr, M.D., Morton A. Stenchever, M.D., William Droegemueuller, M.D., and Arthur L. Herbst, M.D.
http://www.healthsquare.com/fgwh/wh1ch05.htm
http://medical-dictionary.thefreedictionary.com/cervicitis
http://www.moondragon.org/obgyn/disorders/cervicitis.html
http://www.emedicinehealth.com/cervicitis/article_em.htm
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Excellent read. I enjoyed reading it, in this issue of becoming a doctor, I think there always a few points one should think of.