小结
定义
病史和体格检查
关键诊断因素
- risk factors for sexually transmitted infection (STI)
- purulent vaginal or cervical discharge
- intermenstrual/postcoital bleeding
- dysuria and urinary frequency
- easily induced cervical bleeding
其他诊断因素
- dyspareunia
- vulval and/or vaginal inflammation
- strawberry cervix
危险因素
- age 15 to 24 years
- inconsistent condom use
- multiple sexual relationships
- previous STIs
- bacterial vaginosis (BV)
- sex worker
- absence of hydrogen peroxide-producing lactobacilli
- infertility
- education <12 years
诊断性检查
首要检查
- pregnancy test
- wet mount examination of cervical discharge
- nucleic acid amplification testing (NAAT)
- rapid tests (OSOM Trichomonas, AFFIRM VPIII)
- Thayer-Martin agar cervical culture
- Gram stain of cervical discharge
需考虑的检查
- cervical cytology
- herpes simplex virus (HSV) serology
- HIV serology
- hepatitis B and C serologies
- rapid plasma reagin testing
治疗流程
high-risk nonpregnant women
nonpregnant women
pregnant women
recurrent/resistant infections
撰稿人
作者
M. Jonathon Solnik, MD, FACOG, FACS
Associate Professor of Obstetrics & Gynaecology
Head of Gynaecology & Minimally Invasive Surgery
University of Toronto Faculty of Medicine
Mount Sinai Hospital
Toronto
Canada
利益声明
MJS serves as a consultant for Medtronic, Olympus, and Hologic, and on the advisory board for Abbvie. He holds stocks in Felix and Field Trip Inc.
鸣谢
Dr M. Jonathon Solnik would like to gratefully acknowledge Dr Sharon Jakus, a previous contributor to this topic.
利益声明
SJ declares that she has no competing interests.
同行评议者
Sandra R. Valaitis, MD
Associate Professor and Chief
Gynecology and Reconstructive Pelvic Surgery
University of Chicago
Chicago
IL
利益声明
SRV declares that she has no competing interests.
Justin C. Chura, MD
Associate Division Director
Gynecologic Oncology
Crozer Chester Medical Center
Upland
PA
利益声明
JCC declares that he has no competing interests.
Eva Jungmann, FRCP, MSc
Consultant Physician
GUM/HIV Camden Primary Care Trust
Archway Sexual Health Clinic
London
UK
利益声明
EJ declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.全文 摘要
Boyer CB, Shafer MB, Pollack LM, et al. Sociodemographic markers and behavioral correlates of STIs in a nonclinical sample of adolescent and young adult women. J Infect Dis. 2006 Aug 1;194(3):307-15.全文 摘要
Marrazzo JM, Weisenfeld HC, Murray PJ, et al. Risk factors for cervicitis among women with bacterial vaginosis. J Infect Dis. 2006 Mar 1;193(5):617-24.全文 摘要
Scholes D, Grothaus L, McClure J, et al. A randomized trial of strategies to increase Chlamydia screening in young women. Prev Med. 2006 Oct;43(4):343-50. 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Cervical ectropion
- Cervical dysplasia
- Cervical cancer
更多 鉴别诊断指南
- European guideline on the management of Mycoplasma genitalium infections
- British Association for Sexual Health and HIV (BASHH) United Kingdom national guideline on the management of Trichomonas vaginalis 2021
更多 指南患者教育信息
Chlamydia
Genital herpes
更多 患者教育信息
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