Cervicitis

Cervicitis is inflammation of the uterine cervix[1]. Cervicitis in women has many features in common with urethritis in men and many cases are caused by sexually transmitted infections. Death may occur.[2][3] Non-infectious causes of cervicitis can include intrauterine devices, contraceptive diaphragms, and allergic reactions to spermicides or latex condoms.[4] The condition is often confused with vaginismus which is a much simpler condition and easily rectified with simple exercises. [1] Cervicitis affects over half of all women during their adult life.[1]

Cervicitis

Symptoms

Cervicitis may have no symptoms.[1] If symptoms do manifest, they may include:

Causes

Cervicitis can be caused by any of a number of infections, of which the most common are chlamydia and gonorrhea, with chlamydia accounting for approximately 40% of cases.[5] Women who are at risk for chlamydia should be tested for cervicities, even if they have no symptoms.[1] As many half of pregnant women are asymptomatic with a gonorrhea infection of the cervix.[6] Trichomonas vaginalis and herpes simplex are less common causes of cervicitis. There is a consistent association of M. genitalium infection and female reproductive tract syndromes. M. genitalium infection is significantly associated with increased risk of cervicitis.[7][8]

While STIs are the most common cause of cervicitis, there are other potential causes as well: a device inserted into the pelvic area (i.e. a cervical cap, IUD, etc.); an allergy to spermicides or latex in condoms; or, exposure to a chemical.[1]

There are also certain behaviors that can place women at a higher risk for contracting cervicitis. High-risk sexual behavior, a history of STIs, many sexual partners, sex at an early age, and sexual partners who engage in high-risk sexual behavior or have had an STI can increase the likelihood of contracting cervicitis.[1]

Diagnosis

To diagnose cervicitis, a physician will perform a pelvic exam to look for discharge from or redness in the cervix, and swelling of the vaginal walls. Tests may include an inspection of the discharge under a microscope, a Pap test, or tests for gonorrhea or chlamydia.[1]

Prevention

The risk of contracting cervicitis from STIs can be reduced by using condoms during every sexual encounter. Condoms are effective against the spread of STIs like chlamydia and gonorrhea that cause cervicitis. Also, being in a long-term monogamous relationship with an uninfected partner can lower the risk of an STI.[9]

Ensuring that foreign objects like tampons are properly placed in the vagina and following instructions how long to leave it inside, how often to change it, and/or how often to clean it can reduce the risk of cervicitis.[1]. In addition, avoiding potential irritants like douches and deodorant tampons can prevent cervicitis.[1]

Treatment

Once cervicitis is diagnosed, antibiotics are used to treat chlamydia or gonorrhea. Antivirals may be used to treat herpes infections. For post-menopausal women, hormonal therapy with estrogen or progesterone may be prescribed for treatment.[1]

Simple cervicitis will typically heal with no complications if the cause is found and a treatment for that cause is available.[1]

References

  1. ^ a b c d e f g h i j k l "Cervicitis: MedlinePlus Medical Encyclopedia". medlineplus.gov. U.S. National Library of Medicine. Retrieved 7 November 2018.
  2. ^ Workowski KA, Berman SM (August 2006). "Sexually transmitted diseases treatment guidelines, 2006". MMWR Recomm Rep. 55 (RR–11): 1–94. PMID 16888612.
  3. ^ Hynes NA (2008-10-30). "hopkins-abxguide.org". Point-of-care Information Technology. Johns Hopkins University. Retrieved 2010-02-03.
  4. ^ MedlinePlus Encyclopedia Cervicitis
  5. ^ Mitchell, Richard Sheppard; Kumar, Vinay; Robbins, Stanley L.; Abbas, Abul K.; Fausto, Nelson (2007). Robbins basic pathology (8th ed.). Saunders/Elsevier. pp. 716–8. ISBN 978-1-4160-2973-1.
  6. ^ Kenner, Carole (2014). Comprehensive neonatal nursing care (5th ed.). New York, NY: Springer Publishing Company, LLC. ISBN 9780826109750. Access provided by the University of Pittsburgh.
  7. ^ Lis, R.; Rowhani-Rahbar, A.; Manhart, L. E. (2015). "Mycoplasma genitalium Infection and Female Reproductive Tract Disease: A Meta-Analysis". Clinical Infectious Diseases. 61 (3): 418–26. doi:10.1093/cid/civ312. ISSN 1058-4838. PMID 25900174.
  8. ^ "Diseases Characterized by Urethritis and Cervicitis - 2015 STD Treatment Guidelines". www.cdc.gov. Retrieved 2017-12-08.
  9. ^ "Symptoms and causes - Mayo Clinic". www.mayoclinic.org. Mayo Clinic. Retrieved 7 November 2018.

External links

External resources
Chlamydia trachomatis

Chlamydia trachomatis (), commonly known as chlamydia, is a bacterium that can replicate only in human cells. It causes chlamydia, which can manifest in various ways, including: trachoma, lymphogranuloma venereum, nongonococcal urethritis, cervicitis, salpingitis, pelvic inflammatory disease. C. trachomatis is the most common infectious cause of blindness and the most common sexually transmitted bacterium.Different types of C. trachomatis cause different diseases. The most common strains cause disease in the genital tract, while other strains cause disease in the eye or lymph nodes. Like other Chlamydia species, the C. trachomatis life cycle consists of two morphologically distinct life stages: elementary bodies and reticulate bodies. Elementary bodies are spore-like and infectious. Reticulate bodies are the replicative stage and are seen only within host cells.

Endometrioma

Endometrioma is the presence of endometrial tissue in and sometimes on the ovary. It is the most common form of endometriosis. More broadly, endometriosis is the presence of endometrial tissue located outside the uterus. The presence of endometriosis can result in the formation of scar tissue, adhesions and an inflammatory reaction. It is a benign growth. An endometrioma is most often found in the ovary. It can also develop in the cul-de-sac (the space behind the uterus), the surface of the uterus, and between the vagina and rectum.

Enterocele

An enterocele is a protrusion of the small intestines and peritoneum into the vaginal canal.

It may be treated transvaginally or by laparoscopy.

An enterocele may also obstruct the rectum, leading to symptoms of obstructed defecation. Enteroceles can form after treatment for gynecological cancers.

Hematocolpos

Hematocolpos is a medical condition in which the vagina fills with menstrual blood. It is often caused by the combination of menstruation with an imperforate hymen. It is sometimes seen in Robinow syndrome, uterus didelphys, or other vaginal anomalies.

A related disorder is hematometra, where the uterus fills with menstrual blood. It presents after puberty as primary amenorrhoea, recurrent pelvic pain with a pelvic mass. This can be caused by a congenital stenosis of the cervix, or by a complication of a surgical treatment. Mucometrocolpos is the accumulation of mucous secretions behind an imperforate hymen. Mucometrocolpos can sometimes cause abdominal distention.

Intermenstrual bleeding

Intermenstrual bleeding, previously known as metrorrhagia, is uterine bleeding at irregular intervals, particularly between the expected menstrual periods. It is a cause of vaginal bleeding.

In some women, menstrual spotting between periods occurs as a normal and harmless part of ovulation. Some women experience acute mid-cycle abdominal pain around the time of ovulation (sometimes referred to by the German term for this phenomenon, mittelschmerz). This may also occur at the same time as menstrual spotting. The term breakthrough bleeding or breakthrough spotting is usually used for women using hormonal contraceptives, such as IUDs or oral contraceptives, in which it refers to bleeding or spotting between any expected withdrawal bleedings, or bleeding or spotting at any time if none is expected. If spotting continues beyond the first three cycles of oral contraceptive use, a woman should have her prescription changed to a pill containing either more estrogen or more progesterone.Besides the aforementioned physiologic forms, metrorrhagia may also represent abnormal uterine bleeding and be a sign of an underlying disorder, such as hormone imbalance, endometriosis, uterine fibroids, uterine cancer, or vaginal cancer.

If the bleeding is repeated and heavy, it can cause significant iron-deficiency anemia.

List of bacterial vaginosis microbiota

Bacterial vaginosis is caused by an imbalance of the naturally occurring bacteria in the vagina. The normally predominant species of Lactobacilli are markedly reduced. This is the list of organisms that are found in the vagina that are associated with bacterial vaginosis, an infectious disease of the vagina caused by excessive growth of specific bacteria. The census and relationships among the microbiota are altered in BV resulting in a complex bacterial milieu. Some species have been identified relatively recently. Having infections with the listed pathogens increases the risk of acquiring other sexually transmitted infections including HIV/AIDS.

Mutual monogamy

Mutual monogamy is a form of monogamy that exists when two partners agree to be sexually active with only one another. Being in a long-term mutually monogamous relationship reduces the risk of acquiring a sexually transmitted infection (STI). It is one of the most reliable ways to avoid STIs. Those who choose mutual monogamy can be tested before the sexual relationship to be certain they are not infected. This strategy for the prevention of acquiring a sexually transmitted infection requires that each partner remain faithful and does not engage in sexual activity with another partner.Mutual monogamy differs from serial monogamy which is a current monogamous relationship that has not been established in the past and may not continue into the future. Serial monogamy may not result in the reduced risk of contracting a sexually transmitted infection because the past sexual exposures to infection are brought into the new relationship, even though it may be exclusive of other sexual partners. The risk of acquiring a sexually transmitted infection while in a serial monogamous relationship is the same as the risk of those who have concurrent partners. Those with a greater ability to communicate about their commitment are likely to sustain the relationship.

When individuals are mutually monogamous, and are free from STIs/HIV when they enter the relationship, the risk for being infected with STI/HIV acquisition from sexual intercourse is very low. A mutually monogomous relationship lowers the risk of HIV, cervicitis, and other sexually transmitted infections.A mutual monogomous sexual relationship often includes a pledge to stay with the partner and includes the desire for the relationship to last, a psychological attachment and the lack of being able to find another partner. If these conditions remain a priority for both, the "couple is likely committed and mutually monogamous."Being in a long-term mutually monogamous relationship with a partner who has been tested and has negative STI test lowers the chance of acquiring gonorrhea. It is also effective for lowering the risk of syphilis, chlamydia and pubic lice.The lack of a more precise definition of mutual monogamy in the literature confounds the ability to statistically assess its effectiveness.

Mycoplasma genitalium

Mycoplasma genitalium (MG, commonly known as Mgen), is a sexually transmitted, small and pathogenic bacterium that lives on the skin cells of the urinary and genital tracts in humans. Mgen is becoming increasingly common. Resistance to multiple antibiotics is occurring, including azithromycin which until recently was the most reliable line treatment. The bacteria was first isolated from urogenital tract of humans in 1981, and was eventually identified as a new species of Mycoplasma in 1983. It can cause negative health effects in men and women. It also increases the risk factor for HIV spread with higher occurrences in homosexual men and those previously treated with the azithromycin antibiotics.Specifically, it causes urethritis in both men and women, and also cervicitis and pelvic inflammation in women. It presents clinically similar symptoms to that of Chlamydia trachomatis infection and has shown higher incidence rates, compared to both Chlamydia trachomatis and Neisseria gonorrhoeae infections in some populations. Its complete genome sequence was published in 1995 (size 0.58 Mbp, with 475 genes). It was regarded as a cellular unit with the smallest genome size (in Mbp) until 2003 when a new species of Archaea, namely Nanoarchaeum equitans, was sequenced (0.49 Mbp, with 540 genes). However, Mgen still has the smallest genome of any known (naturally occurring) self-replicating organism and thus is often the organism of choice in minimal genome research.

The synthetic genome of Mgen named Mycoplasma genitalium JCVI-1.0 (after the research centre, J. Craig Venter Institute, where it was synthesised) was produced in 2008, becoming the first organism with a synthetic genome. In 2014, a protein was described called Protein M from M. genitalium.

Mycoplasma hominis infection

The exact role of Mycoplasma hominis (and to a lesser extent Ureaplasma) in regards to a number of conditions related to pregnant women and their (unborn) offspring is controversial. This is mainly because many healthy adults have genitourinary colonization with Mycoplasma, published studies on pathogenicity have important design limitations and the organisms are very difficult to detect. The likelihood of colonization with M. hominis appears directly linked to the number of lifetime sexual partners

Neonatal colonization does occur, but only through normal vaginal delivery. Caesarean section appears protective against colonization and is much less common. Neonatal colonization is transient.

Nabothian cyst

A nabothian cyst (or nabothian follicle) is a mucus-filled cyst on the surface of the cervix. They are most often caused when stratified squamous epithelium of the ectocervix (portion nearest to the vagina) grows over the simple columnar epithelium of the endocervix (portion nearest to the uterus). This tissue growth can block the cervical crypts (subdermal pockets usually 2–10 mm in diameter), trapping cervical mucus inside the crypts.

Non-gonococcal urethritis

Nongonococcal urethritis (NGU) is an inflammation of the urethra that is not caused by gonorrheal infection.

For treatment purposes, doctors usually classify infectious urethritis in two categories: gonococcal urethritis, caused by gonorrhea, and nongonococcal urethritis (NGU).

Obstetrical bleeding

Obstetrical bleeding is bleeding in pregnancy that occurs before, during, or after childbirth. Bleeding before childbirth is that which occurs after 24 weeks of pregnancy. Bleeding may be vaginal or less commonly into the abdominal cavity. Bleeding which occurs before 24 weeks is known as early pregnancy bleeding.

Causes of bleeding before and during childbirth include cervicitis, placenta previa, placental abruption and uterine rupture. Causes of bleeding after childbirth include poor contraction of the uterus, retained products of conception, and bleeding disorders.About 8.7 million cases of severe maternal bleeding occurred in 2015 resulting in 83,000 death. Between 2003 and 2009, bleeding accounted for 27% of maternal deaths globally.

Postcoital bleeding

Postcoital bleeding is bleeding from the vagina in women after sexual intercourse and may or may not be associated with pain. The bleeding can be from the uterus, cervix, vagina and other tissue or organs located near the vagina. Postcoital bleeding can be one of the first indications of cervical cancer. There are other reasons why a woman may bleed after intercourse. Some women will bleed after intercourse for the first time but others will not. The hymen may bleed if it is stretched since it is thin tissue. Other activities may have an effect on the vagina such as sports and tampon use. Postcoital bleeding may stop without treatment. In some instances, postcoital bleeding may resemble menstrual irregularities. Postcoital bleeding may occur throughout pregnancy. The presence of cervical polyps may result in postcoital bleeding during pregnancy because the tissue of the polyps is more easily damaged. Postcoital bleeding can be due to trauma after consensual and non-consensual sexual intercourse.A diagnosis to determine the cause will include obtaining a medical history and assessing the symptoms. Treatment is not always necessary.

Reactive arthritis

Reactive arthritis, formerly known as Reiter's syndrome, is a form of inflammatory arthritis that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease. By the time the patient presents with symptoms, often the "trigger" infection has been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.

The arthritis often is coupled with other characteristic symptoms; this was previously referred to as Reiter's syndrome, Reiter's disease or Reiter's arthritis. The term "reactive arthritis" is preferred and increasingly used as a substitute for this designation because Hans Conrad Julius Reiter was not the first to describe the syndrome, and his conclusions regarding its pathogenesis were incorrect, and because he committed war crimes at Buchenwald concentration camp during the World War II.

The manifestations of reactive arthritis include the following triad of symptoms: an inflammatory arthritis of large joints, inflammation of the eyes in the form of conjunctivitis or uveitis, and urethritis in men or cervicitis in women. Arthritis occurring alone following sexual exposure or enteric infection is also known as reactive arthritis. Patients can also present with mucocutaneous lesions, as well as psoriasis-like skin lesions such as circinate balanitis, and keratoderma blennorrhagicum. Enthesitis can involve the Achilles tendon resulting in heel pain. Not all affected persons have all the manifestations.

The clinical pattern of reactive arthritis commonly consists of an inflammation of fewer than five joints which often includes the knee or sacroiliac joint. The arthritis may be "additive" (more joints become inflamed in addition to the primarily affected one) or "migratory" (new joints become inflamed after the initially inflamed site has already improved).Reactive arthritis is an RF-seronegative, HLA-B27-linked arthritis often precipitated by genitourinary or gastrointestinal infections. The most common triggers are intestinal infections (with Salmonella, Shigella or Campylobacter) and sexually transmitted infections (with Chlamydia trachomatis).It most commonly strikes individuals aged 20–40 years of age, is more common in men than in women, and more common in white than in black people. This is owing to the high frequency of the HLA-B27 gene in the white population. It can occur in epidemic form. Patients with HIV have an increased risk of developing reactive arthritis as well.

A large number of cases during World Wars I and II focused attention on the triad of arthritis, urethritis, and conjunctivitis (often with additional mucocutaneous lesions), which at that time was also referred to as Fiessenger-Leroy-Reiter syndrome.

Strawberry cervix

A strawberry cervix is a finding upon physical examination where the cervix has an erythematous, punctate, and papilliform appearance. It is named because of the superficial similar appearance to a strawberry.

As opposed to a more general inflammation of the cervix found in cervicitis, the strawberry cervix appearance is considered to be selectively associated with Trichomonas infections. A clinician discovering this finding would have a high suspicion for Trichomonas infection.

Temafloxacin

Temafloxacin (marketed by Abbott Laboratories as Omniflox) is a fluoroquinolone antibiotic drug which was withdrawn from sale in the United States shortly after its approval in 1992 because of serious adverse effects resulting in three deaths. It is not marketed in Europe.

Ureterovaginal fistula

A ureterovaginal fistula is an abnormal passageway existing between the ureter and the vagina. It presents as urinary incontinence. Its impact on women is to reduce the "quality of life dramatically."

Urethritis

Urethritis is inflammation of the urethra. The most common symptom is painful or difficult urination. It is usually caused by infection with bacteria. The bacterial infection is often sexually transmitted, but not in every instance; it can be idiopathic, for example.

Urethrocele

A urethrocele is the prolapse of the female urethra into the vagina. Weakening of the tissues that hold the urethra in place may cause it to protrude into the vagina. Urethroceles often occur with cystoceles (involving the urinary bladder as well as the urethra). In this case, the term used is cystourethrocele.

Acute
Chronic
Processes
Specific
locations
Sexually transmitted infection (STI) (primarily A50–A64, 090–099)
Bacterial
Protozoal
Parasitic
Viral
General
inflammation
Female diseases of the pelvis and genitals (N70–N99, 614–629)
Internal
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