Symptoms and treatment of acute cervicitis
Acute inflammation of the cervix is called acute cervicitis. Of the acute cervicitis of a bacterial nature, gonorrheal cervicitis is the most common. However, the disease can also be caused by streptococci, enterococci, corynebacteria, mycoplasmas, chlamydia.
Symptoms of acute cervicitis
In most cases, inflammation affects only the endocervical glands, in rare cases affecting squamous epithelium. According to some researchers, the nature of inflammation (constancy, location, path of spread of the infectious process) is determined by the type of pathogen. So, gonococci affect only the epithelial cells of the endocervical glands and spread to the surface of the mucosa. Inflammation caused by streptococci and staphylococci is localized within the endocervical glands, affecting the stroma of the cervix. With the flow of lymph, pathogens reach the other organs of the small pelvis and become the cause of their infection.
The first symptoms of acute cervicitis include the appearance of secretions, the amount and nature of which may vary. Most often they contain an admixture of pus and are profuse in nature, especially when it comes to gonorrhea.
The acute course of the disease may also be accompanied by a slight increase in body temperature, dull pain in the lower abdomen, a feeling of hot flashes in the pelvic organs. Patients may complain of back pain, urinary disorders (dysuria, polyuria), dyspareunia.
When a diagnosis of acute cervicitis is made, in addition to a gynecological examination of the cervix, they resort to microscopic examination of smears, sowing secretions from the cervical canal onto a nutrient medium. The cervix is red, with signs of blood stagnation, edematous. In the cervical canal, a whitish or yellowish exudate is noticeable. The epithelium in the cervical region may be eroded.
With a gonococcal infection, in the preparations of secretions that are stained according to Gram, one can notice gram-negative diplococci inside the cell. In addition, a mixture of gram-negative bacilli and gram-positive cocci can be found in culture, together with a significant concentration of polymorphonuclear leukocytes.
In acute gonorrheal cervicitis, timely diagnosis is carried out in rare cases, since a woman turns to a specialist only if the inflammation affects the uterine appendages. Therefore, pain in the area of the appendages in the acute course of gonorrheal cervicitis may indicate the presence of a specific inflammatory process in the patient, which requires a slightly different treatment than in ordinary acute cervicitis.
During the examination, approximately 5% of women have gonorrhea, and 80% of patients with a positive test result for gonorrhea do not show any manifestations of the disease. Therefore, when gonococci are detected in culture and there are no clinical symptoms of acute cervicitis, gonorrhea cannot be considered the cause of the appearance of secretions.
Treatment of acute cervicitis
Acute cervicitis is treated with antibiotics. If gonococci become the cause of the onset of symptoms, then both partners are treated.
The peculiarities of therapy for a disease that are not caused by gonococci can be determined after a culture, which allows to identify the maximum sensitivity of a particular pathogen to antibiotics. Until the results of such a study are obtained, therapy with broad-spectrum antibacterial agents is carried out.
If the affected area is large enough, with significant areas of excoriation and redness, and the course of the underlying disease is complicated by other symptoms, the doctor prescribes supportive therapy that helps to clear the inflamed tissue and relieve pain.
Cryotherapy or cauterization can cause the spread of pathogens with lymph flow and cause the development of pelviocellulitis, therefore, these procedures are not used in the treatment of acute cervicitis.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
