Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- corrimento vaginal ou cervical purulento
- sangramento intermenstrual/pós-coito
- disúria e polaciúria
- sangramento cervical facilmente induzido
Other diagnostic factors
- dispareunia
- inflamação da vulva e/ou da vagina
- colo uterino em morango
Risk factors
- 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
Diagnostic tests
1st tests to order
- 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
Tests to consider
- Citologia cervical
- sorologia para o vírus do herpes simples (HSV)
- sorologia do HIV
- sorologias de hepatites B e C
- teste de reagina plasmática rápida
Treatment algorithm
mulheres de alto risco não gestantes
mulheres não gestantes
gestantes
infecções recorrentes/resistentes
Contributors
Authors
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
Disclosures
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.
Acknowledgements
Dr M. Jonathon Solnik would like to gratefully acknowledge Dr Sharon Jakus, a previous contributor to this topic.
Disclosures
SJ declares that she has no competing interests.
Peer reviewers
Sandra R. Valaitis, MD
Associate Professor and Chief
Gynecology and Reconstructive Pelvic Surgery
University of Chicago
Chicago
IL
Disclosures
SRV declares that she has no competing interests.
Justin C. Chura, MD
Associate Division Director
Gynecologic Oncology
Crozer Chester Medical Center
Upland
PA
Disclosures
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
Disclosures
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.
References
Key articles
Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Full text Abstract
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. Abstract
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.Full text Abstract
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. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Ectrópio cervical
- Displasia cervical
- Câncer cervical
More DifferentialsGuidelines
- 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
More GuidelinesPatient information
Clamídia
Doença inflamatória pélvica (DIP)
More Patient information
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