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cervicitis
Etiology:
1) Chlamydia trachomatis
2) Neisseria gonorrhoeae
3) idiopathic
Clinical manifestations:
1) most women are asymptomatic
2) vaginal discharge
- yellow exudate from the endocervical canal
3) vaginal mucosa is normal
3) inflamed & friable cervic
4) vaginal bleeding, especially after sexual intercourse
5) dysuria may occur [1]
6) whiff test negative
Laboratory:
1) cervical exudate gram stain
- increased numbers of neutrophils
2) Neisseria gonorrhoeae DNA & Chlamydia trachomatis DNA
3) vaginal fluid pH = 5 (case presentation) [1]
Management:
1) ceftriaxone 250 mg IM once & doxycycline 100 mg BID for 7 days for treatment of both chlamydia & primary gonorrhea [1]
2) ceftriaxone 250 mg IM once & azithromycin 1 g (single oral dose) if patient unlikely to comply with days of doxycycline [1]
3) cefixime 400 mg & doxycycline 100 mg BID for 7 days if ceftriaxone is unavailable
4) treat sexual partner
Related
Chlamydia trachomatis
Neisseria gonorrhoeae (gonococcus, GC)
General
pelvic inflammatory disease (PID)
sexually-transmitted disease; sexually-transmitted infection; venereal disease (STD, STI)
References
- Medical Knowledge Self Assessment Program (MKSAP) 11,16,17,19.
American College of Physicians, Philadelphia 1998,2012,2015,2022.
- Centers for Disease Control and Prevention (CDC)
Cephalosporin susceptibility among Neisseria gonorrhoeae
isolates - United States, 2000-2010.
MMWR Morb Mortal Wkly Rep. 2011 Jul 8;60(26):873-7.
PMID: 21734634
- Wilson JF.
In the clinic. Vaginitis and cervicitis.
Ann Intern Med. 2009 Sep 1;151(5):ITC3-1-ITC3-15
PMID: 19721016