Infectious Disease Compendium

Cervicitis

Diagnosis

On the basis of cervical exam; purulent or mucopurulent discharge.

"Two major diagnostic signs characterize cervicitis: 1) a purulent or mucopurulent endocervical exudate visible in the endocervical canal or on an endocervical swab specimen (commonly referred to as mucopurulent cervicitis) and 2) sustained endocervical bleeding easily induced by gentle passage of a cotton swab through the cervical os. Either or both signs might be present."

Epidemiologic Risks

Sex.

Microbiology

C. trachomatis, N. gonorrhea, HSV, and often more than one at a time.

Empiric Therapy

Recommended Regimens for Presumptive Treatment (CDC)

azithromycin 1 g orally in a single dose
OR
doxycycline 100 mg orally twice a day for 7 days

* Consider concurrent treatment for gonococcal infection if prevalence of gonorrhea is high in the patient population under assessment.

Recommended Regimens for GC*

ceftriaxone 250 mg IM in a single dose

OR if no ceftriaxone is available

cefixime 400 mg orally in a single dose

*Cannot use quinolones unless you know the GC is sensitive.

Pearls

When you treat GC you always treat Chlamydia and vice versa; treat the partner as well if possible. All from the CDC STD Guidelines of 2015.

Rants

Last Update: 06/08/18.