Cervicitis overview: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
The pathophysiology of Cervicitis depends on the etiological agent and the [[physiological]] state of the patient. Under the influence of [[estrogen]], the normal vaginal [[epithelium]] cornifies making it somewhat resistant to infectious agents. The [[endocervix]] is lined by [[columnar epithelium]] which is susceptible to infectious agents leading to cervicitis. | |||
[[Gonococcal]] cervicitis results after the exposure of the cervix to [[N. gonorrhea]] in seminal fluid during sexual intercourse. [[N. gonorrhea]] infectivity is facilitated by type IV pilus-mediated motility of the [[bacterium]]. In the presence of [[seminal fluid]], the bacterial motility is characterized by high velocity, low directional persistence and enhanced microcolony formation.<ref name="pmid24595372">{{cite journal| author=Anderson MT, Dewenter L, Maier B, Seifert HS| title=Seminal plasma initiates a Neisseria gonorrhoeae transmission state. | journal=MBio | year= 2014 | volume= 5 | issue= 2 | pages= e01004-13 | pmid=24595372 | doi=10.1128/mBio.01004-13 | pmc=3958800 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24595372 }} </ref> Once [[pilus]] is attached, local [[inflammation]] results from release of neutrophilic [[cytokines]] leading to [[purulent]] or [[mucopurulent]] discharge. | |||
[[C. trachomatis]] infection is often associated with intense lymphocytic and neutrophilic inflammtory reaction in the affected areas and occasionally with follicular aggregation of [[lymphocyte]].<ref name="pmid7078909">{{cite journal| author=Paavonen J, Vesterinen E, Meyer B, Saksela E| title=Colposcopic and histologic findings in cervical chlamydial infection. | journal=Obstet Gynecol | year= 1982 | volume= 59 | issue= 6 | pages= 712-5 | pmid=7078909 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7078909 }} </ref><ref name="pmid2921049">{{cite journal| author=Dunlop EM, Garner A, Darougar S, Treharne JD, Woodland RM| title=Colposcopy, biopsy, and cytology results in women with chlamydial cervicitis. | journal=Genitourin Med | year= 1989 | volume= 65 | issue= 1 | pages= 22-31 | pmid=2921049 | doi= | pmc=1196182 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2921049 }} </ref> The chronic course of [[chlamydial]] cervicitis is associated with low content of [[cytokines]] mainly [[IL-1]] alpha, IL-1 beta, [[TNF-alpha]] and an elevated concentration of [[IL-8]] in the pathogenesis.<ref name="pmid15346950">{{cite journal| author=Dolgushin II, Kurnosenko IV, Dolgushina VF, Ugaĭ IIu, Abramovskikh OS, Gol'tsfarb VM| title=[Clinical and immunological aspects of cervicitis of chlamydial etiology]. | journal=Zh Mikrobiol Epidemiol Immunobiol | year= 2004 | volume= | issue= 3 | pages= 48-52 | pmid=15346950 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15346950 }} </ref> | |||
==Causes== | ==Causes== | ||
Revision as of 14:29, 27 September 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Cervicitis means nflammation of the tissues of the cervix. Cervicitis has many features in common with urethritis in men. These are commonly due to sexually transmitted infections.
Historical Perspective
Cervicitis was first described formally by Dr. Voilet I. Russell and Dr. D. Cochrane Logan in 1926 during their addresses made before the Medical Society for the Study of Veneral Diseases on 29th January 1926. Before this time, no accurate record was made about the disease in literature.[1]
Classification
Cervicitis may be classified according to the etiology, anatomical location and disease duration as infectious, non-infectious, acute, subacute and chronic cervicitis. The infectious causes are Gonococcal, C. trachomatis and Herpes. Examples of the non-infectious causes are traumatic injury to the cervix, chemical exposure; douching, latex, contraceptive creams, systemic inflammation example Behcet syndrome as well as radiation exposure.
Pathophysiology
The pathophysiology of Cervicitis depends on the etiological agent and the physiological state of the patient. Under the influence of estrogen, the normal vaginal epithelium cornifies making it somewhat resistant to infectious agents. The endocervix is lined by columnar epithelium which is susceptible to infectious agents leading to cervicitis.
Gonococcal cervicitis results after the exposure of the cervix to N. gonorrhea in seminal fluid during sexual intercourse. N. gonorrhea infectivity is facilitated by type IV pilus-mediated motility of the bacterium. In the presence of seminal fluid, the bacterial motility is characterized by high velocity, low directional persistence and enhanced microcolony formation.[2] Once pilus is attached, local inflammation results from release of neutrophilic cytokines leading to purulent or mucopurulent discharge. C. trachomatis infection is often associated with intense lymphocytic and neutrophilic inflammtory reaction in the affected areas and occasionally with follicular aggregation of lymphocyte.[3][4] The chronic course of chlamydial cervicitis is associated with low content of cytokines mainly IL-1 alpha, IL-1 beta, TNF-alpha and an elevated concentration of IL-8 in the pathogenesis.[5]
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. Trichomonas vaginalis and herpes simplex are less common causes of cervicitis. Non-infectious causes of cervicitis can include intrauterine devices, contraceptive diaphragms, and allergic reactions to spermicides or latex condoms.
Differentiating Cervicitis overview from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
History and Symptoms
Mucopurulent cervicitis often is asymptomatic, but some women have an abnormal vaginal discharge and vaginal bleeding (e.g., after sexual intercourse).
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Antibiotics are used to treat bacterial infections, such as chlamydia, gonorrhea, and others. Drugs called antivirals may be used to treat herpes infections. Hormonal therapy (with estrogen or progesterone) may be used in women who have reached menopause (postmenopausal). When these treatments have not worked or when cervicitis has been present for a long time, treatment may include cryosurgery (freezing), electrocauterization, or laser therapy.[6]
Surgery
Prevention
References
- ↑ Russell VI (1926). "DIAGNOSIS AND TREATMENT OF URETHRITIS AND CERVICITIS". Br J Vener Dis. 2 (6): 182–93. PMC 1046487. PMID 21772527.
- ↑ Anderson MT, Dewenter L, Maier B, Seifert HS (2014). "Seminal plasma initiates a Neisseria gonorrhoeae transmission state". MBio. 5 (2): e01004–13. doi:10.1128/mBio.01004-13. PMC 3958800. PMID 24595372.
- ↑ Paavonen J, Vesterinen E, Meyer B, Saksela E (1982). "Colposcopic and histologic findings in cervical chlamydial infection". Obstet Gynecol. 59 (6): 712–5. PMID 7078909.
- ↑ Dunlop EM, Garner A, Darougar S, Treharne JD, Woodland RM (1989). "Colposcopy, biopsy, and cytology results in women with chlamydial cervicitis". Genitourin Med. 65 (1): 22–31. PMC 1196182. PMID 2921049.
- ↑ Dolgushin II, Kurnosenko IV, Dolgushina VF, Ugaĭ IIu, Abramovskikh OS, Gol'tsfarb VM (2004). "[Clinical and immunological aspects of cervicitis of chlamydial etiology]". Zh Mikrobiol Epidemiol Immunobiol (3): 48–52. PMID 15346950.
- ↑ Diseases Characterized by Urethritis and Cervicitis. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/std/tg2015/urethritis-and-cervicitis.htm Accessed on July 28, 2016