Acute cervicitis is less common than chronic cervicitis, which mostly occurs after puerperal infection or infectious abortion.Vaginal trichomonas, mold and gonococcal infections can be accompanied by acute cervicitis.The most common cause of acute cervicitis is gonococcal infection. The pathogen involves cervical mucosal glands and spreads along the mucosal surface to cause superficial infection;Other pathogens such as streptococcus, staphylococcus and enterococcus can directly cause acute cervicitis or secondary infection of endometrium.Streptococcus and Staphylococcus are different from Neisseria gonorrhoeae in that they invade the cervix deeper. Streptococcus invading the lymphatic channels of the cervix can cause pelvic cellulitis, which is more common in infectious abortion or puerperal infection.
When gauze, cotton balls or other foreign bodies are placed in the vagina for a long time, it is easy to induce infection and cause acute cervicitis.
2. Secondary infection
The secondary infection of cervical laceration caused by delivery or abortion is the common cause of acute cervicitis.
3. Vaginitis
When acute trichomonal vaginitis or fungal vaginitis or bacterial vaginitis occurs in the vagina, it can also cause acute cervicitis at the same time;Acute gonococcal cervicitis often occurs in gonococcal infection.
4. Vaginal medication
Washing the vagina with high concentration of acid or alkaline solution or inserting corrosive drugs into the vagina can damage the vagina and cervical tissue, which may cause cervicitis and vaginitis.
clinical manifestation
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Gonococcal cervicitis and chlamydia trachomatis cervicitis mainly invade the columnar epithelium of mucosal glands in the cervical canal. If it spreads upward directly, it can lead to upper genital tract mucosal infection.The general pyogenic bacteria invade the cervical tissue deeper, and can spread upward along the cervical lymphatic vessels on both sides, leading to pelvic connective tissue inflammation.Leucorrhea is the most common, sometimes even the only symptom of acute cervicitis, often purulent.Because cervicitis often coexists with urethritis, cystitis or acute vaginitis, acute endometritis, etc., other symptoms of cervicitis are often covered up, such as varying degrees of lower abdomen, lumbosacral pain and bladder irritation.In case of acute gonococcal cervicitis, there may be fever of varying degrees and increase in white blood cell count.This disease often occurs simultaneously with vaginitis, and acute endometritis can also occur at the same time.
inspect
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Colposcopy examination of acute cervicitis: the cervix is in an acute hyperemia, the mucosa is flushed, and is full of reticular vessels or dotted or spiral vessels.If combined with gland infection, multiple yellow vesicular pus spots are scattered on the surface of the cervix, and the opening of the gland is filled with pus.Under the low power microscope, there are many yellow millet like vesicles, and the cervical canal is full of purulent emboli.Precautions for examination of acute cervicitis:
1. Do not have sex within 24 hours before screening.
2. Do not screen during menstruation.
3. Do not flush the vagina or use drugs in the vagina within 3 days before the examination.
diagnosis
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According to the medical history, symptoms and gynecological examination, it is not difficult to diagnose acute cervicitis. The key is to determine the pathogen.Infections caused by various pathogens can show secretions with different characteristics, which can sometimes be identified by visual inspection, but cervical secretions should still be taken for smear or culture for accurate diagnosis, so as to facilitate targeted treatment.
treatment
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The treatment of acute cervicitis should be thorough.The choice of antibiotics, route of administration, dosage and course of treatment are determined by the pathogen and severity of the disease.At present, the first recommended drug for gonococcal cervicitis is ceftriaxone (ceftriaxone sodium), and the standby drugs include spectinomycin, penicillin, ofloxacin, levofloxacin, enoxacin, etc. Doxycycline should be taken at the same time when treating gonococcal cervicitis.
