扬州大学：《妇产科学》课程教学课件（PPT讲稿）30 女性生殖道感染 GENITAL TRACT INFECTION 2/3

CNoninfectious cervicitisNoninfectious cervicitis can be caused by the following:Local trauma - eg, cervical irritation caused bytampons, a cervical cap, the string from anintrauterine contraceptive device, a pessary, or adiaphragm , Radiation, Chemical irritation - eg,vaginal douches, latex exposure, or contraceptivecreams, Systemic inflammation - eg,Behcet syndrome,Malignanc

1 CNoninfectious cervicitis Noninfectious cervicitis can be caused by the following: Local trauma - eg, cervical irritation caused by tampons, a cervical cap, the string from an intrauterine contraceptive device, a pessary, or a diaphragm , Radiation，Chemical irritation - eg, vaginal douches, latex exposure, or contraceptive creams，Systemic inflammation - eg, Behçet syndrome, Malignanc

The infectious etiologies of cervicitis, all of which aresexually transmitted infections (STIs),aresignificantly more common than the noninfectiouscauses. This article focuses on the infectious etiologiesofcervicitis.Infectious cervicitis may be caused by Chlamydiatrachomatis (see the first image below),Neisseriagonorrhoeae, or herpes simplex virus (HSV).In mostcases of cervicitis,however,labtests fail to isolate anorganism; this is particularly true in women with lowriskfactors

2 The infectious etiologies of cervicitis, all of which are sexually transmitted infections (STIs), are significantly more common than the noninfectious causes. This article focuses on the infectious etiologies of cervicitis. Infectious cervicitis may be caused by Chlamydia trachomatis (see the first image below), Neisseria gonorrhoeae, or herpes simplex virus (HSV) . In most cases of cervicitis, however, lab tests fail to isolate an organism; this is particularly true in women with low risk factors

Clinical ManifestationsChlamydia CurriculumChlamydial CervicitisCDCSource:STD/HIV Prevention Training Center at the University of Washington/Connie CelumandWalterStammSTDPrevention

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HSVCurriculumClinical ManifestationsHerpes:CervicitisCDCSource:Cincinnati STD/HIV Prevention Training CenterSTDPrevention

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The infectious etiologies of cervicitis, all of which areRisk factors,Risk factors for cervicitis include thefollowing:Multiple sex partners,Young ageSingle marital status,Urban residenceLow socioeconomic statusAlcohol or drug use

5 The infectious etiologies of cervicitis, all of which are Risk factors,Risk factors for cervicitis include the following: Multiple sex partners, Young age Single marital status, Urban residence Low socioeconomic status Alcohol or drug use

ComplicationsComplications from untreated infectious cervicitisdepend on the pathogen. Untreated gonorrhea andchlamydia infections can lead pelvic inflammatorydisease (PID), which can then result in infertility,chronic pelvic pain, and ectopic pregnancy.Othermorbidity may include spontaneous abortion,premature rupture of membranes, and pretermdelivery ifinfection is present during pregnancy

6 Complications Complications from untreated infectious cervicitis depend on the pathogen. Untreated gonorrhea and chlamydia infections can lead pelvic inflammatory disease (PID), which can then result in infertility, chronic pelvic pain, and ectopic pregnancy. Other morbidity may include spontaneous abortion, premature rupture of membranes, and preterm delivery if infection is present during pregnancy

Thepelvic examinationThe pelvic examination must be performed in a competentand sensitive manner.The presence of a nursing assistantis advised to help with the examination and to act as achaperone. Always explain to the patient what is going tobe done before proceeding.Begin with a neutral touch onthe patient's thigh and visually investigate the externalgenitalia in good lighting. Note any skin lesions (eg, warts,ulcers, vesicles, excoriations, erythema), inflammation oftheBartholin or Skene glands, or inguinallymphadenopathy

7 The pelvic examination The pelvic examination must be performed in a competent and sensitive manner. The presence of a nursing assistant is advised to help with the examination and to act as a chaperone. Always explain to the patient what is going to be done before proceeding. Begin with a neutral touch on the patient's thigh and visually investigate the external genitalia in good lighting. Note any skin lesions (eg, warts, ulcers, vesicles, excoriations, erythema), inflammation of the Bartholin or Skene glands, or inguinal lymphadenopathy

Speculum examinationChlamydia CurriculumClinical ManifestationsPID CurriculumChlamydial CervicitisNormal CervixwithEctopyCDCSource:STD/HiVPrevention Training CenteraftheUniversity ofWashington/ConnieCelumSource:Sealie STD/HIiV Prevention Training Centerat the UniversilyofWashinglonODOandWalterStammSTDIClaireESevensGonorrheaCurriculumClinical Manifestations"Strawberry"cervixdueto TGonococcal Cervicitisvaginalis

8 Speculum examination