Cervicitis

Infection of the cervix must be distinguished from physiologic ectopy of columnar epithelium, which is common in young women. Mucopurulent cervicitis is characterized by a red edematous cervix with a purulent yellow discharge. The infection may result from a sexually transmitted pathogen such as Neisseria gonorrhoeae, chlamydia, or herpesvirus (which presents with vesicles and ulcers on the cervix during a primary herpetic infection), though in most cases none of these organisms can be isolated.

Mucopurulent cervicitis is an insensitive predictor of either gonorrheal or chlamydial infection and in addition has a low positive predictive value. Treatment should be based on microbiologic testing. Presumptive antibiotic treatment of mucopurulent cervicitis is not indicated unless there is a high prevalence of either N gonorrhoeae or chlamydia in the population or if the patient is unlikely to return for treatment.