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transmitted infections, evaluated for pelvic inflammatory disease (PID), and
counseled on safe sexual practices.
CLINICAL PEARLS AND PITFALLS
The most common etiology of acute cervicitis is infectious.
Cervicitis may be diagnosed incidentally in asymptomatic women.
Sexually active women with cervicitis should be treated empirically for
gonorrhea and chlamydia while test results are pending.

Current Evidence
Cervicitis, or inflammation of the cervix, can be acute or chronic in nature. The
etiology of acute cervicitis is most often an infectious etiology (including
Neisseria gonorrhoeae and Chlamydia trachomatis and potentially Mycoplasma
genitalium ). Many of the cases of acute cervicitis will not have a specific
infectious etiology identified. Other etiologies of acute cervicitis include
mechanical irritation (e.g., tampon, IUD, sexual intercourse) and chemical
irritation (e.g., contraceptive cream, douche). Chronic cervicitis is more often due
to a noninfectious etiology. If untreated, infections can ascend the genitourinary
tract and cause PID which may lead to infertility, chronic pelvic pain, and
increased risk of ectopic pregnancy. In addition, cervical infections can be
transmitted to sexual partners and increases the risk of acquiring HIV infections if
exposed.

Clinical Considerations
Clinical Recognition
Patients with cervicitis may be asymptomatic. Symptomatic patients with
cervicitis present with variable and nonspecific symptoms including purulent
vaginal discharge, intermenstrual bleeding, postcoital bleeding, and dyspareunia.
Less frequently, patients will present with urinary symptoms such as dysuria and
urinary frequency due to a concomitant urethritis. Patients with isolated cervicitis
are unlikely to have fever or significant pain. The presence of these should signal
other conditions such as PID or a herpes simplex virus infection (HSV).

Clinical Assessment
On physical examination, patients with acute cervicitis will have purulent (or
mucopurulent) discharge from the cervix on speculum examination. The clinician
may also notice that the cervix tends to bleed easily after minor trauma from a