Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- corrimento vaginal ou cervical purulento
- sangramento intermenstrual/pós-coito
- disúria e polaciúria
- sangramento cervical facilmente induzido
Outros fatores diagnósticos
- dispareunia
- inflamação da vulva e/ou da vagina
- colo uterino em morango
Factores de riesgo
- idade entre 15 e 24 anos
- uso inconsistente de preservativo
- múltiplas relações sexuais
- ISTs prévias
- vaginose bacteriana (VB)
- profissional do sexo
- ausência de lactobacilos produtores de peróxido de hidrogênio
- infertilidade
- grau de escolaridade <12 anos
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- teste de gravidez
- exame do corrimento cervical em câmara úmida
- teste de amplificação de ácido nucleico (NAAT)
- testes rápidos (OSOM Trichomonas, AFFIRM VPIII)
- cultura cervical em placas de ágar Thayer-Martin
- coloração de Gram de secreção cervical
Pruebas diagnósticas que deben considerarse
- Citologia cervical
- sorologia para o vírus do herpes simples (HSV)
- sorologia do HIV
- sorologias de hepatites B e C
- teste de reagina plasmática rápida
Algoritmo de tratamiento
mulheres de alto risco não gestantes
mulheres não gestantes
gestantes
infecções recorrentes/resistentes
Colaboradores
Autores
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
Divulgaciones
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.
Agradecimientos
Dr M. Jonathon Solnik would like to gratefully acknowledge Dr Sharon Jakus, a previous contributor to this topic.
Divulgaciones
SJ declares that she has no competing interests.
Revisores por pares
Sandra R. Valaitis, MD
Associate Professor and Chief
Gynecology and Reconstructive Pelvic Surgery
University of Chicago
Chicago
IL
Divulgaciones
SRV declares that she has no competing interests.
Justin C. Chura, MD
Associate Division Director
Gynecologic Oncology
Crozer Chester Medical Center
Upland
PA
Divulgaciones
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
Divulgaciones
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.
Referencias
Artículos principales
Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Texto completo Resumen
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. Resumen
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.Texto completo Resumen
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. Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Ectrópio cervical
- Displasia cervical
- Câncer cervical
Más DiferencialesGuías de práctica clínica
- British Association for Sexual Health and HIV (BASHH) United Kingdom national guideline on the management of Trichomonas vaginalis 2021
- European guideline on the management of Mycoplasma genitalium infections
Más Guías de práctica clínicaFolletos para el paciente
Clamídia
Doença inflamatória pélvica (DIP)
Más Folletos para el paciente
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