Cervical motion tenderness, adnexal or significant abdominal tenderness are signs of PID rather than cervicitis. Patients with PID may or may not have a fever. Other signs of sepsis may be present in severe disease. Patients may or may not have external abdominal or pelvic tenderness.
Cervicitis that's caused by gonorrhea or chlamydia can spread to the uterine lining and the fallopian tubes, resulting in pelvic inflammatory disease (PID), an infection of the female reproductive organs that can cause fertility problems if left untreated.
To diagnose cervicitis, your doctor will likely perform a physical exam that includes: A pelvic exam. During this exam, your doctor checks your pelvic organs for areas of swelling and tenderness. He or she may also place a speculum in your vagina to view the upper, lower and side walls of the vagina and the cervix.
It is possible for a woman to have PID and be asymptomatic (without symptoms), or symptoms too mild to notice, for an unknown period of time. PID can be misdiagnosed as appendicitis, ectopic pregnancy, ruptured ovarian cysts or other problems.
The signs and symptoms of pelvic inflammatory disease might be mild and difficult to recognize. Some women don't have any signs or symptoms. When signs and symptoms of pelvic inflammatory disease (PID) are present, they most often include: Pain — ranging from mild to severe — in your lower abdomen and pelvis.
The only way to know for sure if you have PID is to see a doctor. They'll give you tests and talk to you about your symptoms and medical and sexual history.
Diagnosis of pelvic inflammatory disease (PID)
Your doctor will begin by asking you questions about your symptoms, your medical and sexual history, and your personal hygiene habits. Your doctor will then perform a pelvic exam to feel for any swelling and to identify areas that are painful and tender.
Cervicitis can be confused with vulvovaginitis or PID but may also be mistaken for other diseases of the lower female genital tract (see chapter for details). A physical exam can help to establish the diagnosis.
Pelvic inflammatory disease (PID) is a polymicrobial infection of the upper female genital tract: the cervix, uterus, fallopian tubes, and ovaries; abscess may occur. PID may be caused by sexually transmitted infections.
Diagnosis and Tests
Cervicitis can be diagnosed during a full pelvic exam. A Pap smear may also be performed. These tests allow your healthcare provider to analyze your cervical and uterine cells for abnormalities.
It's important to tell your sex partner or partners that you have cervicitis. It may be related to an STI. Any partners should get tested and then treated if they have an STI. This is true even if they don't have symptoms.
Ultrasound is not needed in diagnosing cervicitis, however, when complicated by PID, it may be helpful.
Laparoscopically confirmed visual findings of edema and erythema of the fallopian tubes, clubbing of the fimbriae or the presence of tubo-ovarian abscess are considered the gold standard for diagnosing PID.
Some women may not experience any symptoms when they have cervicitis. Severe cervicitis may lead to a thick, yellow or green vaginal discharge that resembles pus.
Most cases of PID are caused by an infection in the vagina or the neck of the womb (cervix) that has spread higher up. Many different types of bacteria can cause PID. However most cases are the result of a chlamydia or gonorrhoea infection.
Bacterial vaginosis, an imbalance of normal bacteria in the vagina. An allergy to the chemicals found in condoms, spermicides or douches. Injury or irritation caused by things such as diaphragms, tampons or pessaries. A hormonal imbalance.
Diagnostic Considerations. Because cervicitis might be a sign of upper genital tract infection (e.g., endometritis), women should be assessed for signs of PID and tested for C. trachomatis and N. gonorrhoeae with NAAT on vaginal, cervical, or urine samples (553) (see Chlamydial Infections; Gonococcal Infections).
A pelvic exam.
During the exam, your provider will check your pelvic region for tenderness and swelling. Your provider may also use cotton swabs to take fluid samples from your vagina and cervix.
A pelvic ultrasound is a helpful procedure for diagnosing PID. An ultrasound can view the pelvic area to see whether the fallopian tubes are enlarged or whether an abscess is present. In some cases, a laparoscopy may be necessary to confirm the diagnosis.
About 12% of women suffer enough tubal damage from one episode of PID to become infertile. After three episodes of PID, the infertility rate reaches 50%.
Most cases of PID are presumed to occur in 2 stages. The first stage is acquisition of a vaginal or cervical infection. This infection is often sexually transmitted and may be asymptomatic.
Many women do not know they have PID because they do not have any signs or symptoms. When symptoms do happen, they can be mild or more serious. Signs and symptoms include: Pain in the lower abdomen (this is the most common symptom)
It may take upwards of a year for most people to develop PID, but others can develop it earlier, depending on the severity of the infection.