Inflammation of the cervix (cervicitis)
The cervix uteri is also anatomically counted as part of the uterus. For this reason, an inflammation of the cervix is also a form of uterine inflammation. An inflammation of the cervix is called cervicitis in technical jargon.
A distinction can be made between pathogen-induced, i.e. infectious, and non-infectious cervicitis. Depending on the time course of the cervical inflammation, a distinction is made between acute and chronic cervical inflammation. After diagnostic and therapeutic interventions on the uterus, such as a scraping or removal of tissue (biopsy), a non-infectious inflammation of the cervix can occur.
Non-infectious cervicitis can also occur in the context of a malignant tumor. An acute inflammation of the cervix is possible due to a Chlamydia infection with Chlamydia trachomatis of serotype D-K. Chlamydia is the most commonly detected bacteria in cervical inflammation and is sexually transmitted. 10-25% of young and sexually active women suffer from chlamydia infection, but in about 30-50% of cases it occurs without clinical symptoms.
Other pathogens that can cause cervicitis include gonococcus (Neisseria gonorrhoeae) – the disease is known as gonorrhea – and the cell-wall-less bacteria of the genus Mycoplasma and Ureaplasma. Besides bacteria, cervicitis can also be caused by viruses. Viruses that cause inflammation of the cervix are mainly herpes simplex viruses.
Recurring and long-lasting inflammations are called chronic cervicitis. They are caused by changes in the anatomical features of the cervix, such as tumors (polyps). But also the numerous hiding places of the cervical mucosa favour the persistence of the pathogenic germs.
In addition to all of the above-mentioned factors, an intrauterine device (coil) for contraception, vaginal delivery, vaginal surgery or ectopy, i.e. the transfer of tissue from the cervical canal to the surface of the portio, are also factors that can promote cervicitis. The predominant symptom of this form of uterine inflammation is discharge (fluorine). This is yellowish-purulent and malodorous.
If the cervicitis is caused by an infection with gonococci (Neisseria gonorrhoeae), the discharge may also take on a yellowish green color. Occasionally there are complaints during sexual intercourse with contact bleeding. If the urethra is also affected by the inflammation (urethritis), urination becomes more difficult and/or painful.
Affected patients usually feel hardly any impairment of their general condition. After the patient’s medical history, where she complains of the symptoms described above, the doctor can usually find typical signs of cervicitis in the clinical examination. These include, for example, a swollen and reddened portio, the portio being the vaginal part of the uterus.
In addition, a purulent discharge from the cervix can be discharged. This cloudy secretion is an important indication of cervicitis. The taking of a smear, the preparation of a native specimen and the cultivation of a bacterial culture are decisive for the diagnosis.
If bleeding (so-called contact bleeding) occurs during the collection of the smear, this indicates the fragility of the inflamed tissue and thus represents a further indication of cervicitis. Depending on the suspected pathogen, other detection methods can also be used to determine the triggering pathogen.For example, the genetic material of Chlamydia can only be detected with the help of a urine sample. An acute inflammation of the cervix is treated with antibiotics, which are applied into the vein, i.e. systemically.
If the inflammation is caused by a chlamydia infection, a single dose of a tetracycline such as doxycycline is administered over 7 days or a macrolide such as erythromycin or clarithromycin and azithromycin. So far no resistances to tetracyclines and erythromycin have been described. When using the macrolide azithromycin, a single administration of 1g is sufficient.
In the case of a Chlamydia infection, a co-treatment of the partner is necessary to prevent the cured patient from becoming infected again with the untreated and therefore infectious sexual partner. If the cervicitis is caused by gonococci, antibiotic substances are also used. Treatment of first choice for a gonococcal infection (gonorrhea) is the single administration of a combination consisting of the cephalosporin ceftriaxone, which is applied into the vein or muscle, and another antibiotic, more precisely azitromycin, which is administered by mouth. The partner must also undergo therapy in the case of a gonococcal infection.
