eMedicine Specialties > Pediatrics: Surgery > Gynecology

Cervicitis: Follow-up

Author: Latha Chandran, MD, MPH, Associate Professor of Pediatrics, Associate Dean for Academic Affairs, Director, Division of General Pediatrics, State University of New York at Stony Brook School of Medicine
Contributor Information and Disclosures

Updated: Mar 6, 2008

Follow-up

Further Outpatient Care

  • Gonococcal cultures are recommended 4-8 weeks after standard treatment or one week after alternative regimens are used.
  • Routine testing for chlamydial eradication is not indicated after treatment; however, repeat testing may be worthwhile after 1-2 months in patients with a high risk of reinfection to identify inadequate treatment of their partners or new infections.
  • Routine annual screening for chlamydial infection is recommended in all sexually active adolescents because of the high prevalence of asymptomatic females.
  • Treat sexual partners.

Complications

  • Ascending infection
  • Arthritis, rash, or both (from disseminated gonorrhea)

Prognosis

  • The prognosis is excellent when the patient is compliant.

Patient Education

  • Instruct patients to avoid sexual intercourse until treatment efficacy is confirmed.
  • Instruct patients how to prevent reinfection by using condoms.
  • Recommend prevention counseling to patients with sexually transmitted infections.
  • Recommend that patients receive screening for other diseases, including HIV infection and syphilis.
  • For excellent patient education resources, visit eMedicine's Women's Health Center. Also, see eMedicine's patient education article Cervicitis.

Miscellaneous

Special Concerns

  • Adolescent compliance with the recommended regimen is a notable concern.
  • A single dose of azithromycin 1 g PO is effective therapy for chlamydial infections and eliminates the need for ongoing treatment compliance.
  • Isolation of gonococci in cervical or vaginal secretions in a child is definitive evidence of sexual abuse.
 


More on Cervicitis

Overview: Cervicitis
Differential Diagnoses & Workup: Cervicitis
Treatment & Medication: Cervicitis
Follow-up: Cervicitis
References
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References

  1. Marrazzo JM. Mucopurulent cervicitis: no longer ignored, but still misunderstood. Infect Dis Clin North Am. Jun 2005;19(2):333-49, viii. [Medline].

  2. Darville T. Chlamydia. Pediatr Rev. Mar 1998;19(3):85-91. [Medline].

  3. Darville T. Gonorrhea. Pediatr Rev. Apr 1999;20(4):125-8. [Medline].

  4. Simpson T, Oh MK. Urethritis and cervicitis in adolescents. Adolesc Med Clin. Jun 2004;15(2):253-71. [Medline].

  5. Smith KR, Ching S, Lee H, et al. Evaluation of ligase chain reaction for use with urine for identification of Neisseria gonorrhoeae in females attending a sexually transmitted disease clinic. J Clin Microbiol. Feb 1995;33(2):455-7. [Medline].

  6. CDC, Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. Aug 4 2006;55(RR-11):1-94. [Medline]. [Full Text].

  7. CDC. Update to CDC's sexually transmitted diseases treatment guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR Morb Mortal Wkly Rep. Apr 13 2007;56(14):332-6. [Medline]. [Full Text].

  8. Sexually transmitted diseases: gonorrhea, Chlamydia trachomatis, pelvic inflammatory disease and syphilis. In: Emans SJ, Laufer MR, Goldstein DP, et al, eds. Pediatric and Adolescent Gynecology. 4th ed. Philadelphia, PA: Lippincott-Raven; 1998:457-504.

  9. Rome ES. Sexually transmitted diseases: testing and treating. Adolesc Med. Jun 1999;10(2):231-41, vi. [Medline].

  10. Stuart GS, Castano PM. Sexually transmitted infections and contraceptives: selective issues. Obstet Gynecol Clin North Am. 30(4):795-808. [Medline].

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Further Reading

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Keywords

cervicitis, cervix, gonococcal cervicitis, chlamydial cervicitis, vaginal discharge, sexually transmitted disease, STD, cervical infection, cervical inflammation, cervical erythema, vulvovaginitis, endometritis, salpingitis, tubo-ovarian abscess, perihepatitis, gonorrhea, Neisseria gonorrhea, Chlamydia trachomatis, C trachomatis, Neisseria gonorrhea, N gonorrhea vaginal bleeding, PID, pelvic inflammatory disease

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Contributor Information and Disclosures

Author

Latha Chandran, MD, MPH, Associate Professor of Pediatrics, Associate Dean for Academic Affairs, Director, Division of General Pediatrics, State University of New York at Stony Brook School of Medicine
Latha Chandran, MD, MPH is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Medical Editor

Elizabeth Alderman, MD, Director of Fellowship Training Program, Director, Adolescent Ambulatory Service, Clinical Professor, Department of Pediatrics, Division of Adolescent Medicine, Albert Einstein College of Medicine and Montefiore Medical Center
Elizabeth Alderman, MD is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, North American Society for Pediatric and Adolescent Gynecology, and Society for Adolescent Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Wayne Wolfram, MD, MPH, Clinical Associate Professor, Departments of Pediatrics, Children's Hospital and University of Cincinnati
Wayne Wolfram, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Pediatrics, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

Paul D Petry, DO, FACOP, FAAP, Consulting Staff, Freeman Pediatric Care, Freeman Health System
Paul D Petry, DO, FACOP, FAAP is a member of the following medical societies: American Academy of Osteopathy, American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association
Disclosure: Nothing to disclose.

Chief Editor

Maureen Strafford, MD, Arnold P Gold Foundation Associate Professor, Departments of Anesthesiology and Pediatrics, Tufts University and Tufts-New England Medical Center
Maureen Strafford, MD is a member of the following medical societies: American Medical Women's Association, American Pain Society, American Society of Anesthesiologists, International Anesthesia Research Society, Society for Education in Anesthesia, Society for Pediatric Anesthesia, and Society of Cardiovascular Anesthesiologists
Disclosure: Nothing to disclose.

 
 
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