acute cervicitis

Acute Cervicitis: Symptoms, Causes, and Diagnosis

Acute cervicitis is a sudden onset of inflammation in the cervix, which can be caused by various factors. The symptoms of acute cervicitis may include:

• Bleeding between menstrual periods
• Pain with intercourse or during a pelvic exam
• Abnormal vaginal discharge

According to [1], acute cervicitis is often due to infection, such as chlamydia or gonorrhea, although in many cases, the specific infection cannot be determined. Other causes of acute cervicitis include herpes simplex virus (HSV), Trichomonas vaginalis, and Mycoplasma genitalium.

Acute cervicitis can also be caused by non-infectious sources, such as irritation or injury to the cells that line the cervix [6]. If left untreated, the germs causing acute cervicitis may move up into the uterus and fallopian tubes, leading to Pelvic Inflammatory Disease (PID) [4].

Diagnosing acute cervicitis typically involves a physical exam, including a pelvic exam and specimen collection [11]. A healthcare provider can usually identify cervicitis easily during an examination, especially if symptoms are present.

Causes of Acute Cervicitis

The most common infectious cause of cervicitis is Chlamydia trachomatis, followed by Neisseria gonorrhea. Other causes include herpes simplex virus (HSV), Trichomonas vaginalis, and Mycoplasma genitalium [5]. Often, a pathogen cannot be identified.

References

[1] Cervicitis can be acute or chronic: Acute cervicitis starts suddenly. [4] If not treated,

Common Signs and Symptoms of Acute Cervicitis

Acute cervicitis, a sudden onset of symptoms, can manifest in various ways. The following are some common signs and symptoms associated with this condition:

• Fluid coming from the vagina: One of the earliest signs of acute cervicitis is fluid discharge from the vagina.
• Pelvic pain: Pain or discomfort in the pelvic area is another symptom of acute cervicitis.
• Bleeding between periods: Abnormal vaginal bleeding, such as bleeding after sex or between menstrual periods, can be a sign of acute cervicitis.
• Bleeding after sex: Bleeding after intercourse is also a possible symptom of acute cervicitis.
• Urinary problems: In some cases, acute cervicitis can cause urinary problems, including frequent, difficult, or painful urination.

These symptoms are often caused by an infection, such as chlamydia or gonorrhea, which can lead to inflammation and irritation of the cervix. It's essential to seek medical attention if you experience any of these symptoms, as prompt treatment can help alleviate discomfort and prevent complications.

References:

• [1] Symptoms of Cervicitis. ... Signs and symptoms, if present, may include: Grayish or pale yellow vaginal discharge; Abnormal vaginal bleeding, such as bleeding after sex or between periods;
• [3] These are the most common symptoms of cervicitis: Fluid coming from the vagina. Pelvic pain. Bleeding between periods. Bleeding after sex. Urinary problems.
• [5] Usually treatment for chlamydia and gonorrhea.
• [9] Pain or pressure — Discomfort may be felt in the pelvis, abdomen or lower back. Urinary problems — Urination may be frequent, difficult or painful.
• [10] Possible symptoms of cervicitis include bleeding between menstrual periods, pain with intercourse or during a pelvic exam, and abnormal vaginal discharge.

To diagnose acute cervicitis, several diagnostic tests can be performed.

Physical Exam and Specimen Collection

A pelvic exam is typically the first step in diagnosing cervicitis. During this exam, a healthcare provider checks the pelvic organs for areas of swelling and tenderness. A speculum may also be placed in the vagina to view the upper, lower, and side walls of the vagina and the cervix [1]. A specimen collection may also be performed to collect cervical discharge or vaginal fluid for further testing.

Nucleic Acid Amplification Tests (NAATs)

NAATs are commonly used to diagnose acute cervicitis. These tests can detect the genetic material of various pathogens, including Chlamydia trachomatis and Neisseria gonorrhea [6]. NAATs include enzyme immunoassay (EIA), direct fluorescent antibody (DFA) staining, DNA probe, and PCR assay.

Other Diagnostic Tests

In addition to NAATs, other diagnostic tests may be performed to rule out other conditions or to confirm the diagnosis of acute cervicitis. These tests may include:

• Enzyme immunoassay (EIA)
• Direct fluorescent antibody (DFA) staining
• DNA probe
• PCR assay

Diagnostic Considerations

It's essential to consider that cervicitis might be a sign of upper genital tract infection, such as endometritis. Women should be assessed for signs of PID (Pelvic Inflammatory Disease) [7].

References:

[1] Context 1: To diagnose cervicitis, your doctor will likely perform a physical exam that includes: A pelvic exam.

[6] Context 6: Feb 15, 2022 — They include enzyme immunoassay (EIA), direct fluorescent antibody [DFA] staining, DNA probe, and PCR assay. Nucleic acid amplification tests (...

[7] Context 7: Diagnostic Considerations. Because cervicitis might be a sign of upper genital tract infection (e.g., endometritis), women should be assessed for signs of PID...

Treatment Options for Acute Cervicitis

Acute cervicitis, an inflammation of the cervix, can be caused by various factors such as sexually transmitted infections (STIs) or other infectious bacteria. The treatment options for acute cervicitis typically involve antibiotics to clear the infection and alleviate symptoms.

• Antibiotics: Doctors commonly prescribe antibiotics as a first-line treatment for acute cervicitis caused by bacterial infections like chlamydia, gonorrhea, or mycoplasma genitalium [1]. Antibiotics such as doxycycline or azithromycin are often used to treat these types of infections.
• Specific antibiotic regimens: The choice of antibiotic regimen may depend on the specific causative agent and local resistance patterns. For example, doxycycline is recommended for treating cervicitis caused by Chlamydia trachomatis [3].
• Combination therapy: In some cases, a combination of antibiotics may be prescribed to treat acute cervicitis, especially if there are multiple causative agents involved.

It's essential to note that treatment should always be guided by laboratory confirmation of the causative agent and consideration of local resistance patterns. Additionally, both partners in a sexual relationship should receive treatment simultaneously to prevent reinfection [2].

References

[1] Marrazzo J. Acute cervicitis. https://www... (Context 2)

[2] Cervicitis. Two major diagnostic signs characterize cervicitis: ... (Context 4)

[3] The purpose of this report is to summarize and critically appraise the evidence available regarding the treatment and management of cervicitis in non-pregnant women. This will include evidence on the comparative clinical effectiveness of doxycycline versus azithromycin for cervicitis caused by Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium (Context 5)

Differential Diagnosis of Acute Cervicitis

Acute cervicitis, an inflammation or infection of the cervix, can be challenging to diagnose due to its similarity with other conditions. The differential diagnosis for acute cervicitis includes:

• Pelvic Inflammatory Disease (PID): A condition that occurs when bacteria from the vagina and cervix spread to the upper reproductive organs, causing inflammation and potentially leading to infertility and chronic pelvic pain.
• Vaginitis: An inflammation or infection of the vagina, which can be caused by bacterial vaginosis, yeast infections, or trichomoniasis.
• Endometritis: An inflammation of the endometrium, the lining of the uterus.
• Adenitis: An inflammation of the lymph nodes in the pelvic area.

These conditions can present with similar symptoms to acute cervicitis, such as:

• Abnormal vaginal discharge or bleeding
• Pelvic pain or tenderness
• Fever

To differentiate between these conditions, a healthcare provider may perform a physical examination, take a medical history, and order diagnostic tests, such as:

• Pap smear: A test that collects cells from the cervix to check for abnormal cell growth.
• Endocervical culture: A test that checks for bacterial or viral infections in the cervix.
• Ultrasound: An imaging test that uses sound waves to create images of the reproductive organs.

A correct diagnosis is essential to provide appropriate treatment and prevent complications. [1][2][3][4]

References:

[1] Context 10: Cervicitis is a clinical syndrome characterized by inflammation of primarily the columnar epithelium of the uterine endocervix. It can be acute or chronic, with acute having infectious causes, and chronic having mostly non-infectious sources.

[2] Context 11: Symptoms may be more noticeable in acute cervicitis, which is often caused by sexually transmitted infections (STIs) or other infectious bacteria.

[3] Context 12: Other clinical signs of inflammation, such as persistent endocervical bleeding (intermenstrual or post-coital vaginal bleeding), can be induced by various conditions, including PID and vaginitis.

[4] Context 14: Cervicitis is typically the consequence of infection with sexually acquired pathogens, most commonly Chlamydia trachomatis or Neisseria gonorrhoeae.