acute cervicitis
Introduction
Introduction to acute cervicitis Acute cervicitis (acutecervieitis) is an acute inflammation caused by pathogen infection of the cervix, mainly in infectious abortion, puerperal infection, unclean sexual activity, cervical injury or vaginal foreign body, causing infection when the pathogen enters. Trichomonas vaginalis, mold and gonorrhea infections are often accompanied by acute cervicitis. Some patients are asymptomatic. Symptoms are mainly characterized by increased vaginal discharge, mucoid purulence, genital itching and burning sensation caused by vaginal secretions. In addition, there may be backache and lower abdominal pain, as well as inter-menstrual bleeding, bleeding after sexual intercourse and other symptoms. If combined with urinary tract infections, urgency, frequent urination, and dysuria may occur. basic knowledge Probability ratio: 75% of female infections Susceptible people: adult women Mode of infection: non-infectious Complications: infertility, urinary tract infection
Cause
Causes of acute cervicitis
Acute cervicitis (acute cervicitis) is mainly caused by the pathogens of sexually transmitted diseases, Neisseria gonorrhoeae and Chlamydia trachomatis. Acute cervicitis caused by Staphylococcus, Streptococcus and Enterococcus is rare.
Caused by vaginal inflammation (25%):
Acute trichomonas vaginitis or fungal vaginitis, bacterial vaginitis can also cause acute cervical inflammation; acute gonococcal cervicitis often occurs when gonorrhea infection.
Irregular vaginal washing (20%):
Some women like to wash the vagina or vulva with lotion, which destroys the cervical tissue and causes cervicitis. Washing the vagina with a high concentration of acidic or alkaline solution, or placing corrosive drugs into the vagina can damage the vagina and cervical tissue, which may cause cervicitis and vaginitis.
Surgical injury (10%):
Secondary infections of cervical laceration caused by childbirth or abortion or gynecological surgery are common causes of acute cervicitis.
Foreign body in the vagina (10%):
When gauze, cotton balls or other foreign objects are placed in the vagina for too long, it is easy to induce infection and cause acute cervicitis.
Frequent sex life (15%):
Sexual life is too frequent, unclean sex or too many sexual partners can increase the chance of cervical infection.
Pathogenesis
At present, the common clinical acute cervicitis is mucopurulent cervicitis (MPC), which is characterized by the appearance of purulent or mucopurulent secretions on the cervical canal or cervical cannula swab specimen; When the cervical canal is wiped, it is easy to induce intracervical hemorrhage. The MPC pathogens are mainly Chlamydia trachomatis and Neisseria gonorrhoeae, but some MPC causes are unclear.
Chlamydia trachomatis and Neisseria gonorrhoeae infection of the cervical columnar epithelium, spread along the mucosal surface caused by shallow infection, the lesion is obvious in the cervical canal, in addition to the cervical columnar epithelium, Neisseria gonorrhoeae often invades the urethral transitional epithelium, the paraurethral gland and The vestibular gland, staphylococcus, and streptococcus are more likely to affect the cervical lymphatics and invade the deep interstitial of the cervix.
The naked eye sees the redness of the cervix, the mucosa of the cervical canal is congested, the edema, the purulent secretion can flow out through the external cervix, the vascular congestion, the cervical mucosa and the submucosal tissue are seen under the microscope, and a large number of polymorphonuclear leukocytes infiltrate around the gland, visible in the glandular cavity. Purulent secretions.
Prevention
Acute cervicitis prevention
Do a good job in publicity and education, pay attention to hygiene during puerperium, and avoid iatrogenic infections.
1, pay attention to menstrual and sexual health: pay attention to vulva and vaginal cleansing. In the case of childbirth, abortion, cervical physical therapy, infection should be prevented, and sexual life should be avoided in the short term. Avoid unclean sex life, unclean sex is easy to bring into various pathogens, and induce cervicitis and even cervical cancer.
2, to avoid sexual life chaos: cervicitis and palace cancer mostly occur in married women, occurred in the unmarried, very few, indicating that it is closely related to sex life. The squamous epithelium of the cervix in adolescence is not yet mature, and sexual life tends to cause squamous cells to fall off and cause cervicitis.
3, repeated abortion or pregnancy and childbirth, stimulation or injury to the cervix, resulting in abnormal proliferation of the cervical epithelium, and then can develop into cancer. Unmarried women, not paying attention to contraceptives after marriage, repeated abortions or increased the chance of cervicitis. Therefore, it is necessary to take contraceptive measures seriously to avoid damage to the cervix caused by multiple births or induced abortions. Avoid premature, excessive, over-frequency fertility and miscarriage. Both childbirth and abortion can cause damage to the cervix, providing an opportunity for bacterial invasion.
Complication
Acute cervicitis complications Complications infertility urinary tract infection
Can be complicated by infertility, urinary tract infection.
Symptom
Acute cervicitis symptoms Common symptoms Acute cervicitis reactive cells change urinary frequency band blood secretions urinary pain backache vaginal secretions increased purulent secretions bladder stimulation vaginal discharge increased
Increased vaginal discharge is the most common acute cervicitis, sometimes even the only symptoms, often purulent, because cervicitis often with urethritis, cystitis or acute vaginitis, acute endometritis, etc., often make cervicitis Other symptoms are covered, such as different degrees of lower abdomen, lumbosacral pain and bladder irritation, etc., acute gonococcal cervicitis, there may be varying degrees of fever and leukocytosis.
Some patients are asymptomatic. Symptoms are mainly characterized by increased vaginal discharge, mucopurulent, genital itching and burning sensation caused by vaginal secretions. In addition, there may be backache and lower abdomen pain, or intermenstrual Bleeding, bleeding after sexual intercourse and other symptoms, if combined with urinary tract infection, urgency, frequent urination, dysuria, gynecological examination see cervical congestion, edema, mucosal valgus, purulent discharge from the cervical canal, cervical tenderness, touch It is easy to bleed. If it is Neisseria gonorrhoeae infection, due to the paraurethral gland, vestibular gland involvement, urethral orifice, vaginal mucosa congestion, edema and excessive purulent secretions.
Examine
Acute cervicitis examination
Secretory examination, pathogen culture and bacterial sensitivity test, enzyme-linked immunosorbent assay (ELISA) and nucleic acid detection.
Histopathological examination.
Gynecological examination see cervical congestion, edema, mucosal eversion, purulent discharge from the cervical canal, cervical tenderness, easy to contact with bleeding, if Neisseria gonorrhoeae infection, due to paraurethral gland, vestibular gland involvement, visible Urethral orifice, vaginal mucosa congestion, edema and a lot of purulent secretions.
Diagnosis
Diagnosis and diagnosis of acute cervicitis
diagnosis
According to the history and symptoms, it is not difficult to see the diagnosis in the clinic. After wiping off the surface secretion of the cervix, insert it into the cervical canal with a small cotton swab, and see the yellow or yellow-green mucopurulent purulent secretion on the white cotton swab. The smear of the secretion is stained with Gram. If there are more than 10 spectroscopy fields per light microscope or more than 30 neutrophils per high power field, MPC can be diagnosed. Chlamydia and gonorrhea should be used for MPC. Detection of Neisseria.
Differential diagnosis
1, different causes identification: acute cervicitis caused by trichomoniasis infection, scattered under the mucosa, such as scattered rose petals, mild cervicitis caused by mold, the surface of the cervical mucosa is tightly covered with a white membrane, Forced to remove the white film, easy to cause bleeding.
2, should be differentiated from cervical cancer.
