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Cervicitis
Inflammation of the tissues of the cervix is known as cervicitis.
Cervicitis in women has many features in common with urethritis in
men.
Cervicitis can be caused by any of a number of infections, of which
the commonest are chlamydia, genital herpes, and gonorrhea.
Mucopurulent cervicitis (MPC) is characterized by a purulent or
mucopurulent endocervical exudate visible in the endocervical canal or
in an endocervical swab specimen. Some specialists also diagnose MPC
on the basis of easily induced cervical bleeding. Although some
specialists consider an increased number of polymorphonuclear
leukocytes on endocervical Gram stain as being useful in the diagnosis
of MPC, this criterion has not been standardized, has a low
positive-predictive value (PPV), and is not available in some
settings. MPC often is asymptomatic, but some women have an abnormal
vaginal discharge and vaginal bleeding (e.g., after sexual
intercourse). MPC can be caused by C. trachomatis or N. gonorrhoeae;
however, in most cases neither organism can be isolated. MPC can
persist despite repeated courses of antimicrobial therapy. Because
relapse or reinfection with C. trachomatis or N. gonorrhoeae usually
does not occur in persons with persistent cases of MPC, other
non-microbiologic determinants (e.g., inflammation in the zone of
ectopy) might be involved.
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Patients who have MPC should be tested for C. trachomatis and for N.
gonorrhoeae with the most sensitive and specific test available.
However, MPC is not a sensitive predictor of infection with these
organisms; most women who have C. trachomatis or N. gonorrhoeae do not
have MPC.
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