Cervicitis

Background

• Inflammation of the cervix most commonly caused by Chlamydia (about 40%) and Gonorrhea
  • Less commonly caused by Trichomonas and HSV-2

Clinical Features

• Mucopurulent endocervical discharge
• May see endocervical bleeding easily induced by cotton swab
• Frequently asymptomatic
  • Women may complain of abnormal vaginal discharge or post-coital vaginal bleeding

Differential Diagnosis

Pelvic Pain

Pelvic origin

• Urinary Tract Infection
• Ectopic
• Ovarian torsion
• Endometriosis
• PID
• Cervicitis
• Ectopic Pregnancy
• Ovarian Torsion
• Spontaneous abortion
• Septic abortion
• Myoma (degenerating)
• Ovarian cyst (rupture)
• Tubo-ovarian abscess
• Mittelschmerz
• Sexual assault/trauma
• Ovarian hyperstimulation syndrome

Abdominal origin

• Appendicitis
• Kidney stone
• Psoas abscess
• Mesenteric adenitis
• Incarcerated hernia
• Diverticulitis
• Pyelonephritis

Evaluation

• Endocervical swab (for GC, Chlamydia)
• Wet mount
• Urine pregnancy test

Management

• Cefixime 400mg PO x1 OR
  • Azithromycin 1g PO x1
• Add Flagyl 2g PO x1 if concern for trichomoniasis

Disposition

• Discharge

See Also

• Sexually Transmitted Diseases (STD)

External Links

• http://www.cdc.gov/std/treatment/2010/urethritis-and-cervicitis.htm

References

Authors

Catie Reynolds, Ross Donaldson, Michael Holtz, Neil Young, Daniel Ostermayer