Cervicitis laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Diagnosis of cervicitis is mostly clinical however, a finding of >10 [[WBC]] in vaginal fluid, in the absence of [[trichomoniasis]], may indicate [[endocervical]] [[inflammation]] caused specifically by [[C. trachomatis]] or [[N. gonorrhea]] although culture is more accurate for [[gonococcal]] cervicitis.<ref name="pmid6896368">{{cite journal| author=McLellan R, Spence MR, Brockman M, Raffel L, Smith JL| title=The clinical diagnosis of trichomoniasis. | journal=Obstet Gynecol | year= 1982 | volume= 60 | issue= 1 | pages= 30-4 | pmid=6896368 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6896368 }} </ref> | |||
The use of nucleic acid amplification tests is very helpful for the diagnosis of trichomoniasis.<ref name="pmid26042815">{{cite journal| author=Workowski KA, Bolan GA, Centers for Disease Control and Prevention| title=Sexually transmitted diseases treatment guidelines, 2015. | journal=MMWR Recomm Rep | year= 2015 | volume= 64 | issue= RR-03 | pages= 1-137 | pmid=26042815 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26042815 }} </ref> | |||
Wet mount microscopy and direct visualisation have low sensitivity in detecting N. gonorrhea and T. vaginalis, because of this symptomatic women with cervicitis and negative microscopy should receive further testing (i.e., culture or other FDA-cleared method). Although [[HSV]]-2 infection has been associated with cervicitis, the utility of specific testing (i.e., culture or serologic testing) for [[HSV]]-2 is unknown. DNA amplification techniques has good sensitivity, but are not yet approved for diagnostic purposes of [[Trichomoniasis]].<ref name="pmid15054166">{{cite journal| author=Swygard H, Seña AC, Hobbs MM, Cohen MS| title=Trichomoniasis: clinical manifestations, diagnosis and management. | journal=Sex Transm Infect | year= 2004 | volume= 80 | issue= 2 | pages= 91-5 | pmid=15054166 | doi= | pmc=1744792 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15054166 }} </ref> | |||
Microscopy (wet prep) and vaginal pH are useful for identifying [[bacterial vaginosis]] which may show clue cells.<ref name="pmid20221621">{{cite journal| author=Storti-Filho A, Souza PC, Souza RJ, Pereira MW, Mello IC, Svidizinski TI et al.| title=Prevalence of clue cells suggestive for Gardnerella vaginalis in population-based cervical screening in the public versus private health care in Maringá, Paraná, Brazil. | journal=Arch Gynecol Obstet | year= 2011 | volume= 283 | issue= 4 | pages= 781-5 | pmid=20221621 | doi=10.1007/s00404-010-1400-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20221621 }} </ref> | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
Diagnosis of cervicitis is mostly clinical however, some laboratory findings consistent with cervicitis include : | |||
* A finding of >10 [[WBC]] in vaginal fluid, in the absence of [[trichomoniasis]], may indicate [[endocervical]] [[inflammation]] caused specifically by [[C. trachomatis]] or [[N. gonorrhea]], however, culture is more accurate for [[gonococcal]] cervicitis.<ref name="pmid6896368">{{cite journal| author=McLellan R, Spence MR, Brockman M, Raffel L, Smith JL| title=The clinical diagnosis of trichomoniasis. | journal=Obstet Gynecol | year= 1982 | volume= 60 | issue= 1 | pages= 30-4 | pmid=6896368 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6896368 }} </ref> | |||
*The use of nucleic acid amplification tests for the diagnosis of trichomoniasis.<ref name="pmid26042815">{{cite journal| author=Workowski KA, Bolan GA, Centers for Disease Control and Prevention| title=Sexually transmitted diseases treatment guidelines, 2015. | journal=MMWR Recomm Rep | year= 2015 | volume= 64 | issue= RR-03 | pages= 1-137 | pmid=26042815 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26042815 }} </ref> | |||
*Wet mount microscopy and direct visualisation have low sensitivity in detecting N. gonorrhea and T. vaginalis, because of this symptomatic women with cervicitis and negative microscopy should receive further testing (i.e., culture or other FDA-cleared method). | |||
*Although [[HSV]]-2 infection has been associated with cervicitis, the utility of specific testing (i.e., culture or serologic testing) for [[HSV]]-2 is unknown. | |||
*DNA amplification techniques has good sensitivity, but are not yet approved for diagnostic purposes of [[Trichomoniasis]]<ref name="pmid15054166">{{cite journal| author=Swygard H, Seña AC, Hobbs MM, Cohen MS| title=Trichomoniasis: clinical manifestations, diagnosis and management. | journal=Sex Transm Infect | year= 2004 | volume= 80 | issue= 2 | pages= 91-5 | pmid=15054166 | doi= | pmc=1744792 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15054166 }} </ref> | |||
*Microscopy (wet prep) and vaginal pH are useful for identifying [[bacterial vaginosis]] which may show clue cells.<ref name="pmid20221621">{{cite journal| author=Storti-Filho A, Souza PC, Souza RJ, Pereira MW, Mello IC, Svidizinski TI et al.| title=Prevalence of clue cells suggestive for Gardnerella vaginalis in population-based cervical screening in the public versus private health care in Maringá, Paraná, Brazil. | journal=Arch Gynecol Obstet | year= 2011 | volume= 283 | issue= 4 | pages= 781-5 | pmid=20221621 | doi=10.1007/s00404-010-1400-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20221621 }} </ref> | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]
Overview
Diagnosis of cervicitis is mostly clinical however, a finding of >10 WBC in vaginal fluid, in the absence of trichomoniasis, may indicate endocervical inflammation caused specifically by C. trachomatis or N. gonorrhea although culture is more accurate for gonococcal cervicitis.[1] The use of nucleic acid amplification tests is very helpful for the diagnosis of trichomoniasis.[2] Wet mount microscopy and direct visualisation have low sensitivity in detecting N. gonorrhea and T. vaginalis, because of this symptomatic women with cervicitis and negative microscopy should receive further testing (i.e., culture or other FDA-cleared method). Although HSV-2 infection has been associated with cervicitis, the utility of specific testing (i.e., culture or serologic testing) for HSV-2 is unknown. DNA amplification techniques has good sensitivity, but are not yet approved for diagnostic purposes of Trichomoniasis.[3] Microscopy (wet prep) and vaginal pH are useful for identifying bacterial vaginosis which may show clue cells.[4]
Laboratory Findings
Diagnosis of cervicitis is mostly clinical however, some laboratory findings consistent with cervicitis include :
- A finding of >10 WBC in vaginal fluid, in the absence of trichomoniasis, may indicate endocervical inflammation caused specifically by C. trachomatis or N. gonorrhea, however, culture is more accurate for gonococcal cervicitis.[1]
- The use of nucleic acid amplification tests for the diagnosis of trichomoniasis.[2]
- Wet mount microscopy and direct visualisation have low sensitivity in detecting N. gonorrhea and T. vaginalis, because of this symptomatic women with cervicitis and negative microscopy should receive further testing (i.e., culture or other FDA-cleared method).
- Although HSV-2 infection has been associated with cervicitis, the utility of specific testing (i.e., culture or serologic testing) for HSV-2 is unknown.
- DNA amplification techniques has good sensitivity, but are not yet approved for diagnostic purposes of Trichomoniasis[3]
- Microscopy (wet prep) and vaginal pH are useful for identifying bacterial vaginosis which may show clue cells.[4]
References
- ↑ 1.0 1.1 McLellan R, Spence MR, Brockman M, Raffel L, Smith JL (1982). "The clinical diagnosis of trichomoniasis". Obstet Gynecol. 60 (1): 30–4. PMID 6896368.
- ↑ 2.0 2.1 Workowski KA, Bolan GA, Centers for Disease Control and Prevention (2015). "Sexually transmitted diseases treatment guidelines, 2015". MMWR Recomm Rep. 64 (RR-03): 1–137. PMID 26042815.
- ↑ 3.0 3.1 Swygard H, Seña AC, Hobbs MM, Cohen MS (2004). "Trichomoniasis: clinical manifestations, diagnosis and management". Sex Transm Infect. 80 (2): 91–5. PMC 1744792. PMID 15054166.
- ↑ 4.0 4.1 Storti-Filho A, Souza PC, Souza RJ, Pereira MW, Mello IC, Svidizinski TI; et al. (2011). "Prevalence of clue cells suggestive for Gardnerella vaginalis in population-based cervical screening in the public versus private health care in Maringá, Paraná, Brazil". Arch Gynecol Obstet. 283 (4): 781–5. doi:10.1007/s00404-010-1400-x. PMID 20221621.