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
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) and 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, and/or intermenstrual vaginal bleeding (e.g., especially after sexual intercourse).
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[1][2]
- 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:[3][4]
- 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.[5]
- 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.
References
- ↑ Marrazzo JM, Wiesenfeld HC, Murray PJ, Busse B, Meyn L, Krohn M; et al. (2006). "Risk factors for cervicitis among women with bacterial vaginosis". J Infect Dis. 193 (5): 617–24. doi:10.1086/500149. PMID 16453256.
- ↑ 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. PMID: 2921049
- ↑ Holló P, Jókai H, Herszényi K, Kárpáti S (2015). "[Genitourethral infections caused by D-K serotypes of Chlamydia trachomatis]". Orv Hetil. 156 (1): 19–23. doi:10.1556/OH.2015.30078. PMID 25544050.
- ↑ Barlow D, Phillips I (1978). "Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects". Lancet. 1 (8067): 761–4. PMID 76760.
- ↑ McLellan R, Spence MR, Brockman M, Raffel L, Smith JL (1982). "The clinical diagnosis of trichomoniasis". Obstet Gynecol. 60 (1): 30–4. PMID 6896368.