Differentials
Cervical ectropion
SIGNS / SYMPTOMS
Commonly seen in adolescent women, pregnant women, and women on contraceptive pills.
Usually no history of purulent discharge.
Oestrogenic influence on cervical epithelium.
INVESTIGATIONS
Microscopic examination does not reveal infection or evidence of leukorrhoea.
Cervical dysplasia
SIGNS / SYMPTOMS
Patient may report a history of abnormal cervical cytology.
INVESTIGATIONS
Pap smear: abnormal cervical cytology.
Colposcopy: acetowhite epithelium, abnormal vascular patterns (punctations, mosaicism), gross lesion.
Cervical biopsy: cervical intraepithelial neoplasia.
Cervical cancer
SIGNS / SYMPTOMS
Patient may report a history of abnormal cervical cytology.
May present with heavy or irregular intermenstrual vaginal bleeding along with abnormal vaginal discharge.
INVESTIGATIONS
Pap smear: abnormal cervical cytology.
Colposcopy: abnormal vascularity, white change with acetic acid, or obvious exophytic lesions.
Cervical biopsy: confirms diagnosis histologically and identifies subtype.
Pelvic inflammatory disease (PID)
SIGNS / SYMPTOMS
Patient presents with abdominal pain and tenderness, pelvic pain and cervical tenderness, fever, nausea/anorexia.
Clinical examination of cervical motion tenderness and abdominal tenderness, as well as sign of fever or leukocytosis, can be used to diagnose this condition.
Patients with Chlamydia trachomatis cervicitis, if left untreated, carry a 40% risk of developing PID.
INVESTIGATIONS
Transvaginal ultrasound: classic signs are tubal wall thickness greater than 5 mm, incomplete septae within the tube, fluid in the cul-de-sac, and a cogwheel appearance on the cross-section of the tubal view; may also see tubo-ovarian abscess; may be normal.
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