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Key Features

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  • In most cases, no organism is isolated

  • Most common causes include Chlamydia trachomatis or Neisseria gonorrhoeae

  • Herpes simplex virus, Trichomonas vaginalis, and Mycoplasma genitalium are less common causes

  • Bacterial vaginosis is recognized as a cause

  • Cervicitis can also be present without a sexually transmitted infection

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Clinical Findings

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  • Characterized by

    • Purulent or mucopurulent endocervical exudate visible in the endocervical canal or on an endocervical swab

    • Easily induced bleeding with the passage of a cotton swab through the cervical os

  • Often asymptomatic, but many patients have an abnormal vaginal discharge or postcoital bleeding

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Diagnosis

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  • Although endocervical Gram stain may show an increased number of polymorphonuclear leukocytes, it has a low positive predictive value and is not recommended for diagnosis

  • Patients with cervicitis should be tested for C trachomatis, N gonorrhoeae, and trichomoniasis by using the most sensitive and specific tests available

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Treatment

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  • Azithromycin, 1 g orally as single dose

  • Doxycycline, 100 mg orally twice a day for 7 days

  • Ceftriaxone, 250 mg intramuscularly as single dose plus azithromycin, 1 g orally as single dose

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