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CONTINUING MEDICAL EDUCATION: SEXUALLY TRANSMITTED INFECTIONS
DOI: 10.1016/j.eimce.2018.12.011
Available online 14 July 2019
Cervicitis: Etiology, diagnosis and treatment
Cervicitis: etiología, diagnóstico y tratamiento
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Victoria Ortiz-de la Tablaa,
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ortiz_vic@gva.es

Corresponding author.
, Félix Gutiérrezb
a Servicio de Microbiología, Hospital Universitario San Juan de Alicante, Sant Joan d’Alacant, Alicante, Spain
b Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Alicante, Spain
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Received 04 December 2018. Accepted 07 December 2018
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Table 1. Factors potentially involved in cervicitis with negative microbiological studies and possible mechanisms.
Table 2. Microbial and non-microbial etiology of cervicitis.
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Abstract

Cervicitis is the inflammation of the cervix. It is usually caused by an infectious agent, usually sexually transmitted. Cervicitis is frequently asymptomatic and silent infection can cause complications of the upper genital tract. The symptoms are usually nonspecific, the most significant being an increase in vaginal discharge and/or intermenstrual bleeding. For its diagnosis, there are commercial systems based on molecular techniques that include almost all of the known pathogens associated with cervicitis, although cultures should not be abandoned due to the need to conduct studies of susceptibility to antibiotics. It is recommended to initiate an empirical antibiotic therapy that covers Chlamydia trachomatis and Neisseria gonorrhoeae in the case of women at high risk of infection by these pathogens, especially if the follow-up is not assured or adequate diagnostic tests are not available. In women with low risk of sexually transmitted infection, antibiotic therapy should be adjusted to the results of the microbiological results.

Keywords:
Cervicitis
Sexually transmitted infections
Microbial diagnosis
Resumen

La cervicitis es un cuadro de inflamación del cuello uterino. Suele ser causada por un agente infeccioso, generalmente de transmisión sexual. Frecuentemente es asintomática, y la infección silente puede originar complicaciones del tracto genital superior. Los síntomas suelen ser inespecíficos, y los más significativos son aumento del flujo vaginal y/o sangrado intermenstrual. Para su diagnóstico existen sistemas comerciales basados en técnicas moleculares que incluyen la casi totalidad de los patógenos conocidos asociados a cervicitis, aunque los cultivos no deben abandonarse por la necesidad de realizar estudios de sensibilidad a los antibióticos. Se recomienda iniciar un tratamiento empírico que incluya C. trachomatis y N. gonorrhoeae en el caso de mujeres con elevado riesgo de infección por dichos patógenos, sobre todo si el seguimiento no está asegurado o no se dispone de pruebas diagnósticas adecuadas. En mujeres con bajo riesgo el tratamiento deberá ajustarse a los resultados de las pruebas microbiológicas.

Palabras clave:
Cervicitis
Infecciones de transmisión sexual
Diagnóstico microbiológico

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