Hi good evening , today i'll be posting a brief review on infectious cervicitis.Cervix is an organ located just below the body of the uterus .It consists of two parts , the ectocervix & the endocervix.Ectocervix is the portion of the cervix that projects into the vagina.In order to describe the infections of the cervix , it can be divided into infections of the ectocervix & infections of the endocervix.
INFECTIONS OF THE ENDOCERVIX: are most commonly caused by two bacteria:Neisseria gonorrheae & Chlamydia trachomatis.The infections may present with no symptoms at all or present with purulant discharge.This type of purulant discharge may also occur in infections due to herpes simplex,trichomonads,bacterial vaginosis etc.The purulant discharge may also occur without any infection of the cervix.
Chlamydia infection of the endocervix is very common .It is a very important cause of subsequent infertility.
SCREENING FOR CHLAMYDIA INFECTION should be done in:
a.All pregnant women below the age of 24 years & older pregnant women who are at high risk.
b.All non pregnant sexually active young women below 24 years & older non-pregnant womwn who are at high risk.
c.screening is not recommended for women older than 24 years who are not at high risk.
DIAGNOSIS OF GONORRHEA & CHLAMYDIA INFECTION:
1. nucleic acid amplification test is the most sensitive test for diagnosis of both the infections.
2.Gram's stain of the vaginal swabs.
TREATMENT:Previously fluoroquinolone antibiotics[ciprofloxacin] were recommended for the treatment of gonorrhea infection.But at present resistance has developed to it,now the drug of choice for gonorrhea infection is ceftriaxone.Other drugs that can be given for this infection are azithromycin,doxycycline,cefixime,cefotaxim,ceftizoxime etc.
For chlamydia infection the drug of choice is azithromycin single dose.Doxycycycline can also be used[for 7 days].
Both partners should receive treatment.
INFECTION OF ECTOCERVIX:Can be caused by a variety of infections like HPV[human papilloma virus ],HSV[herpes simplex virus],Treponema pallidum[SYPHILIS],hemophillus ducreyi,parasites like schistosomiasis,amoebiasis in certain countries etc.
Today i will describe in short two very important causes namely HPV & HSV.
HPV has many types,40 of which cause mucosal[lining of the cervix] infection.HPV can cause lesion in the labia,vagina,cervix.Type 6 & 11 cause exophytic[irregular growth like] lesions , these are called condyloma acuminatum, it has not been linked to pre-cancerous lesion.But type 16,18,31,33,35 etc causes flat warts which has been linked to pre-cancerous lesions.Kits are available in the market ,to distinguish between the benign types[6,11] and risky types[16,18,31,33 etc,]
DIAGNOSIS is made by 1.reflex HPV testing of thin layer cytology.
2.any lesion suspected ofHPV should be confirmed by biopsy.
Infection of the cervix is caused by both HSV 1 & HSV 2.In primary infection[first time infection]cervix infection is much more common.It may have no symptoms or present with purulant discharge,pain,ulcers in the cervix etc.
Any primary infection of the cervix with HPV infection should be treated with anti-virals like acyclovir,valacyclovir,famcyclovir.
For more information on this topic please post a comment or consult your physician or
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INFECTIONS OF THE ENDOCERVIX: are most commonly caused by two bacteria:Neisseria gonorrheae & Chlamydia trachomatis.The infections may present with no symptoms at all or present with purulant discharge.This type of purulant discharge may also occur in infections due to herpes simplex,trichomonads,bacterial vaginosis etc.The purulant discharge may also occur without any infection of the cervix.
Chlamydia infection of the endocervix is very common .It is a very important cause of subsequent infertility.
SCREENING FOR CHLAMYDIA INFECTION should be done in:
a.All pregnant women below the age of 24 years & older pregnant women who are at high risk.
b.All non pregnant sexually active young women below 24 years & older non-pregnant womwn who are at high risk.
c.screening is not recommended for women older than 24 years who are not at high risk.
DIAGNOSIS OF GONORRHEA & CHLAMYDIA INFECTION:
1. nucleic acid amplification test is the most sensitive test for diagnosis of both the infections.
2.Gram's stain of the vaginal swabs.
TREATMENT:Previously fluoroquinolone antibiotics[ciprofloxacin] were recommended for the treatment of gonorrhea infection.But at present resistance has developed to it,now the drug of choice for gonorrhea infection is ceftriaxone.Other drugs that can be given for this infection are azithromycin,doxycycline,cefixime,cefotaxim,ceftizoxime etc.
For chlamydia infection the drug of choice is azithromycin single dose.Doxycycycline can also be used[for 7 days].
Both partners should receive treatment.
INFECTION OF ECTOCERVIX:Can be caused by a variety of infections like HPV[human papilloma virus ],HSV[herpes simplex virus],Treponema pallidum[SYPHILIS],hemophillus ducreyi,parasites like schistosomiasis,amoebiasis in certain countries etc.
Today i will describe in short two very important causes namely HPV & HSV.
HPV has many types,40 of which cause mucosal[lining of the cervix] infection.HPV can cause lesion in the labia,vagina,cervix.Type 6 & 11 cause exophytic[irregular growth like] lesions , these are called condyloma acuminatum, it has not been linked to pre-cancerous lesion.But type 16,18,31,33,35 etc causes flat warts which has been linked to pre-cancerous lesions.Kits are available in the market ,to distinguish between the benign types[6,11] and risky types[16,18,31,33 etc,]
DIAGNOSIS is made by 1.reflex HPV testing of thin layer cytology.
2.any lesion suspected ofHPV should be confirmed by biopsy.
Infection of the cervix is caused by both HSV 1 & HSV 2.In primary infection[first time infection]cervix infection is much more common.It may have no symptoms or present with purulant discharge,pain,ulcers in the cervix etc.
Any primary infection of the cervix with HPV infection should be treated with anti-virals like acyclovir,valacyclovir,famcyclovir.
For more information on this topic please post a comment or consult your physician or
click
Click Here!
A1 Web Links Blog Directory
