Cervicovaginitis

Cervicovaginitis is a condition whereby the vagina and cervical squamous epithelial cells (mucosa) become inflamed due to infection or other cause. This damages the surface cells, and leads to ulceration and reduced epithelial thickness, since the top (superficial) layer of cells is lost. The superficial and intermediate cells (containing glycogen) can be lost, with the deeper cells swollen due to an influx of neutrophils in the space between cells.

Symptoms of cervicovaginitis

• Ulceration or lesions on the vaginal or cervical epithelium
• Excess discharge
• White discharge
• Frothy, grey or greenish-yellow discharge
• Foul smelling (malodorous) discharge
• Discharge may not smell bad
• Lower abdominal pain
• Back ache
• Itching
• Redness
• Painful sex (dyspareunia)
• Upon examination, there will be evidence of congestion and ulceration, patchy white areas

Risk factors include living in a tropical area in a developing country.

Infectious causes of cervicovaginitis

• Trichomonas vaginalis
• Candida albicans
• BV-causing bacteria – Bacteroides, Peptostreptococcus, Gardnerella vaginalis, Gardnerella mobiluncus
• Chlamydia trachomatis
• Haemophilus ducreyi
• Mycoplasma hominis
• Streptococcus
• Escherichia coli
• Staphylococcus (MRSA)
• Neisseria gonorrhoea
• Herpes simplex virus (HSV1 or HSV2)

Non-infectious causes of cervicovaginitis

•  A foreign body – IUD, tampon, etc.
• Trauma to the area
• Irritant creams or gels

Diagnosis and treatment of cervicovaginitis

Diagnosis is made by a doctor after an examination and testing. Usually the source of the inflammation can be found, and treatment pursued – either antimicrobials or removing the irritant.