Cervicitis is an inflammation of cervix that opens into vagina. 

The main symptoms include unusual vaginal discharge, bleeding between periods or after sexual intercourse. 

Cervicitis spreads to uterus, ovaries, and fallopian tubes from cervix that affects reproductive organs. Vaginal opening and vagina may appear red and irritated. 

Acute cervicitis has sudden, severe symptoms, while chronic lasts for months or longer. 

Infections from vagina to cervix can cause inflammation, sores, and pus-like discharge as an early symptom of infection. 

Overlap between vulvovaginitis and cervicitis due to contiguous female genital tract, these both are lower genital tract infections. 

CDC estimates 19 million new STIs annually, with nearly half among aged between 15 to 24 years old. 

Trichomonas is a curable STI with 3.7 million infected people, 70% asymptomatic. About 7.4 million new cases yearly in women and men. 

Chlamydial infections rose steadily in past 2 decades, with 1.3 million cases in 2010. 

Trichomonas vaginalis can infect the cervix, leads to inflammation and discharge. 

HSV infection rates hard to estimate due to many initial infections are asymptomatic or unrecognized.  

HPV prevalence linked to cervical cancer varies globally. Sub-Saharan Africa has highest HPV prevalence, with 26% of Nigerian women affected. Cervicitis not linked to race. 

Common causes of cervicitis are infections like C trachomatis and N gonorrhoeae, spread mainly through sexual transmission.  

Non-infectious cervicitis causes trauma, radiation, irritation, inflammation, and malignancy. 

Risk factors for cervicitis as follows: 

Single marital status 

Multiple sex partners 

Urban residence 

Low socioeconomic status 

Antibiotics used to treat gonorrhea, chlamydia, and trichomoniasis while antivirals reduce herpes simplex virus outbreaks. 

Untreated infections such as gonorrhea and chlamydia may cause to pelvic inflammatory disease complications.  

Types of HPV lead to cervical cancer, while untreated HSV in newborns cause disability, blindness, and low birth weight. 

Cervicitis affect women of all ages including young and older females. 

Abdominal Examination 

Bimanual Examination 

Pelvic Examination 

Speculum Examination 

Asymptomatic cervicitis is common in gonorrhea, chlamydia, and T vaginalis infections.  

E.g., discharge, dysuria, and bleeding 

Most HSV patients experience mild recurring outbreaks with prodromal itching or tingling before vesicles. 

Admit female patients with suspected pelvic inflammatory disease who are pregnant, immunocompromised, unable to take oral medications, or failed outpatient therapy. 

Disseminated infection requires intensive monitoring and parenteral medication to prevent instability. 

Medical treatment for cervicitis includes presumptive therapy for infectious cases or specific antibiotics once etiology known. 

Administer presumptive therapy to high-risk women for chlamydia when follow-up is uncertain, or tests are insensitive. 

All sexual partners need treatment to prevent reinfection and sexual activity must pause for 7 days. 

Avoid alcohol during metronidazole or tinidazole treatment, plus 24 hours post-metronidazole or 72 hours post-tinidazole. 

During metronidazole treatment, breastfeeding should be stopped in lactating women and resumed 12 to 24 hours after the last dose. 

Treatment for cervicitis and HIV in women is the same as non-infected women. 

No established treatments for women with persistent cervicitis and no evidence of reinfection or bacterial vaginosis after exposure to STI. 

Consult infectious disease specialist for treatment failure or managing patients infected with drug-resistant microbial strain. 

OB/GYN and Women\'s Health

Use condoms to decrease STI risk and prevent cervicitis caused due to sexually transmitted infections. 

Regular STI screenings recommended for sexually active individuals with multiple partners for early detection. 

Encourage proper wiping technique and mild soaps to prevent spread of bacteria and irritation in sensitive areas such as the vagina and urethra. 

Consider hormone replacement therapy for menopausal women with vaginal atrophy and cervicitis symptoms. 

Proper education and awareness about cervicitis should be provided and its related causes, and how to stop it with management strategies. 

Appointments with a gynecologist and preventing recurrence of disorder is an ongoing life-long effort. 

OB/GYN and Women\'s Health

• Ceftriaxone: It is used as first-line therapy for gonococcal cervicitis as broad-spectrum third-generation cephalosporin. 
• Cefixime: It is a potent third-generation cephalosporin used to treat gonorrhea to block penicillin-binding proteins. 
• Spectinomycin: It inhibits bacterial protein synthesis at 30S ribosomal subunit. 
• Doxycycline: It inhibits protein synthesis, that binds to 30S and 50S ribosomal subunits in susceptible strains. 
• Metronidazole: It is synthetic antibacterial agent indicated in the treatment of T vaginalis infections. 
• Ofloxacin: It inhibits bacterial DNA gyrase that prevent DNA processes to cause cell death. 

OB/GYN and Women\'s Health

• Acyclovir: It is a synthetic purine nucleoside analogue, that inhibits human herpes viruses including HSV-1, HSV-2, VZV, Epstein-Barr, and CMV. 
• Famciclovir:  It turns into penciclovir when consumed and activated by viral thymidine kinase. 

OB/GYN and Women\'s Health

• Podofilox: It is a topical antimitotic derived from Coniferae and Berberidaceae. 
• Fluorouracil: It is a cycle-specific drug used in combination with leucovorin for effectiveness. 

OB/GYN and Women\'s Health

• Tinidazole: It is a 5-nitroimidazole derivative that treats protozoal infections due to cell extract reduction of nitro group in Trichomonas. 

OB/GYN and Women\'s Health

Cryogenic treatment freezes abnormal cervical tissues with liquid nitrogen to replace them with healthy cells. 

Surgeons also suggested loop electrosurgical excision procedure and cervical polypectomy in some cases. 

OB/GYN and Women\'s Health

In the diagnosis phase, evaluation of physical examination including medical history and laboratory tests to confirm diagnosis. 

Pharmacologic therapy is very effective in the treatment phase as it includes use of antivirals, antibiotics, antiprotozoal agents and surgical intervention. 

In supportive care and management phase, patients should receive required attention such as lifestyle modification and rehabilitation. 

The regular follow-up visits with the gynaecologist are schedule to check the improvement of patients along with treatment response.