Symptoms and treatment of chlamydial cervicitis

Chlamydia in women begins, as a rule, with infection of the so-called “lower urogenital tract” - the urethra, bladder, external genital organs, vagina and even the cervix.

Chlamydia is caused by microorganisms of chlamydia - semi-bacteria, semi-viruses. Chlamydia in women provokes the development of diseases such as

  • chlamydial urethritis - inflammation of the urethra,
  • cystitis (cystourethritis, urethrocystitis) - inflammation of the bladder,
  • cervicitis - inflammation of the cervical canal of the cervix,
  • vulvitis (colpitis) - inflammation of the external genital organs,
  • bartholinitis - inflammation of the bartholin glands,
  • erosion of the cervix and other diseases.

All these diseases do not have specific features characteristic only for chlamydial infection and often proceed without the observed symptoms.

However, any disease caused by chlamydia is dangerous. Firstly, it is almost imperceptible. Nevertheless, chlamydia, even without symptoms, is a huge destructive work, comparable to the destruction of a tornado. Secondly, it can spread upwards - to the so-called “upper parts of the urogenital tract” - to the uterus, ovaries, fallopian tubes (for more details see “Ascending chlamydial infection”).

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Chlamydia is in itself a very dangerous disease. For a woman, chlamydia is doubly dangerous: it not only leads to the development of serious complications in it, including infertility, chlamydia in a woman is able to be transmitted to the fetus in utero and the newborn during childbirth, leading to the development of the child’s most serious inflammatory diseases of the eyes, lungs, ear, and goal nose, etc.

If you care about your health, the health of your loved one, about planned and real children, at the first signs of inflammation in the urethra or genitals, it is better to consult a gynecologist and thereby exclude the presence of dangerous infections. Remember: genital infections cannot be cured on their own - they need to be treated, treated quickly, and competent doctors and a serious medical center should be chosen to preserve their health.

Below we will touch on in the most general form several of the most common diseases of the "lower section" that cause chlamydia in women, and which require immediate treatment:

  • Urethritis
  • Cervicitis
  • Cystitis
  • Paraurethritis
  • Vulvit
  • Vaginitis (colpitis)
  • Bartholinitis

Chlamydial urethritis in women, it often affects not only the urethra, but, at the same time, the cervix. More than 90% of patients with a positive test for chlamydia in the urethra do not experience any discomfort and do not have vivid manifestations of the disease. Patients do not show complaints of violation of the act of urination (common with urethritis) such as increased or decreased urination, increased nightly urination, pain, burning, itching, pain when urinating, enuresis.

Therefore, the main way to avoid chlamydia is consciousness. If you notice some discomfort in the urethra, consult your doctor. Only a specialist can tell you how serious the changes you are observing are and whether they require treatment. Do not wait until chlamydia causes inflammation of the uterus, fallopian tubes, and ovaries. At the stage of urethritis, chlamydia is still quickly and easily treatable.

Chlamydial Cervicitis (endocervicitis, cervicitis chlamydialis - inflammation of the cervical mucosa).

Cervicitis is one of the most common diseases that cause chlamydia. As already mentioned, chlamydia prefer to "settle" in a special, cylindrical epithelium. The cervix is ​​lined with just such an epithelium, so chlamydia primarily affects it.

The most characteristic symptoms of chlamydial cervicitis are abundant mucopurulent vaginal discharge, itching of the vulva. However, more than half of patients with chlamydial cervicitis do not observe symptoms of the disease. We repeat that for the prevention of complications of chlamydia, it is necessary at the slightest suspicious symptoms and sensations to consult a gynecologist and regularly undergo a gynecological examination - at least once every half a year.

The danger of cervicitis is that chlamydia from the cervix can easily go to the uterus and further and lead to the development of more serious diseases and complications. If chlamydia causes cervicitis during pregnancy, this can trigger the development of a miscarriage.

Chlamydial cystitis (inflammation of the bladder) develops as a result of the spread of chlamydial infection from the urethra to the bladder. Patients present complaints characteristic of any cystitis - drawing pains in the lower abdomen, frequent urination or urging them, accompanied by pains. There are no symptoms characteristic of chlamydial lesions of the bladder.

Our medical center Euromedprestige provides only high-quality medical care. Our doctors do not prescribe antibiotic doses, observing inflammation. Therefore, before treating an inflammatory disease and cystitis in particular, you will be assigned a diagnosis to identify the cause of inflammation. Only after finding out “who” has settled in the bladder, a treatment will be prescribed: not all infections are treated equally, and we care about your health with accurate diagnostics: we do not treat what is not.

Chlamydial Paraurethritis - inflammation of the paraurethral glands, or paraurethral passages.

Paraurethral glands are located on the sides of the external opening of the urethra. Paraurethritis is a complication of acute or chronic urethritis that has not been treated in a timely manner.

Chlamydial paraurethritis is especially insidious. Firstly, he does not seek to detect symptoms. The patient does not experience almost any unpleasant signs of disease. Secondly, even in the treatment of other inflammatory diseases, paraurethral passages often remain a "bomb shelter" for chlamydia, whence those with not completely cured chlamydia again start their triumphal procession through our urinary and genital organs. This is the reason for the prolonged course of chlamydia, their relapse, the development of negative consequences and the further spread of chlamydia. This is the reason why the diagnosis of chlamydia and the treatment of chlamydia are MANDATORY.

Chlamydial vulvitis (inflammation of the vulva). Chlamydia-induced vulvitis is also not unlike inflammation caused by other infections. Any unpleasant sensations in patients are also weakly expressed. Complaints of itching or burning in the external genitalia are rare.

Chlamydial vaginitis (colpitis) - inflammation of the vaginal mucosa. Patients are usually concerned about symptoms such as vaginal discharge, itching, burning sensation.

Chlamydial vaginitis usually does not occur in women with normal hormonal levels. Basically, it develops in girls (vulvovaginitis), elderly and pregnant women. The hormonal background in these categories of patients has been changed - as a result, the nature of the vaginal epithelium and its protective properties have been changed.

Often, chlamydial vaginitis in women develops as a secondary disease - as a result of endocervicitis (inflammation of the mucous membrane of the cervical canal). Flowing unhindered discharge from the cervical canal of the cervix fall on the vaginal mucosa.

Frequent exacerbations of chlamydial cervicitis can provoke erosion, as a result of irritation from secretions freely flowing into the vagina from the cervical canal of the cervix.

Chlamydial bartholinitis, bartholinitis chlamydialis - inflammation of the large glands of the vestibule. The onset of the disease is usually characterized by inflammation of the duct of the Bartholin gland. As a result of inflammation, the outer opening of the duct narrows and the secretion produced by the gland stagnates in it, potentially forming a cyst or as a false abscess called an abscess, abscess, under the skin as a result of infection. An abscess in some cases can be opened independently.

Only at this stage can you observe the temperature, swelling of the labia, its redness. The transition of the process to the chronic stage is no longer accompanied by any complaints of pain. Discomfort may periodically manifest as itching in the external genital area. The only symptom of bartholinitis conceived is a reddish spot the size of a pea with a central dark red dot.

Chronic inflammation and the cyst of the large gland of the vestibule are not accompanied by any painful symptoms, and only with large sizes of the cyst, patients indicate awkwardness in movement, difficulties during sexual intercourse. Chlamydial bartholinitis mainly proceeds sluggishly, is not accompanied by certain complaints and is poor in symptoms.

So, we found out what diseases cause chlamydia. All these diseases are chlamydia. Of course, not every inflammatory disease in a woman is the result of chlamydia or other genital infections. But every discomfort, discharge, itching or burning, redness requires immediate attention. All these symptoms, and each one individually, are a serious reason for contacting a gynecologist and a thorough diagnosis. Our medical center Euromedprestige is a center of the highest medical service, where you will always get help.

Symptoms of Chlamydial Cervicitis

The cause of the pathology can be various microorganisms, including gonococci and chlamydia. The causative agents of infection enter the body of a healthy person during intercourse (oral contact) from an infected partner. Clinical symptoms of the disease are noted 20 days after infection.

The disease proceeds practically without complaints from patients. Any symptoms of chlamydial cervicitis are most often absent, so patients may not suspect that they urgently need to see a doctor about the treatment of chlamydia. In rare cases, small mucous secretions can be noted, sometimes with an admixture of pus, without cutting pain. The asymptomatic course of the pathology is a serious problem, since it can contribute to the spread of the infectious process to the parts of the reproductive system located above, while the course of the disease becomes even more severe.

An accurate diagnosis - "chlamydial cervicitis" - can only be done by a gynecologist. When examining patients, as a rule, a study of the structure of the cells of the cervical canal, a smear examination under a microscope, as well as a bacteriological study are carried out. More accurate diagnosis allows enzyme immunoassay and immunofluorescence analysis.

Chlamydial Cervicitis Treatment

The specifics of treatment of cervicitis determines the nature of the pathogen. In the acute course of the disease, antibiotics and sulfonamides are prescribed, if the cause of the pathology is sexually transmitted infections, then the therapy is selected individually.

On their own, patients are recommended to douche the vagina with the use of solutions of furatsilina, antiseptics, including plant origin, such as sage, chamomile.

It is important to remember that therapy is prescribed for both sexual partners in order to avoid relapse. Given the asymptomatic course of the disease, it is recommended not to postpone a visit to the gynecologist, take tests prescribed by a doctor, consult a specialist after unprotected sex and if infection is suspected. All these measures to prevent the development of pathology allow you to identify the disease at the initial stage and to treat chlamydial cervicitis in a short time.

Expert Editor: Pavel Aleksandrovich Mochalov | D.M.N. general practitioner

Education: Moscow Medical Institute I. Sechenov, specialty - "Medical business" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".

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Causes and symptoms of cervicitis

Inflammation can develop against a background of sexually transmitted diseases, or after an injury to the cervix by foreign objects, including barrier contraception. The cause of cervicitis can also be a tumor process.

Treatment of cervicitis with folk remedies

With diagnosed cervicitis, treatment with alternative methods can be carried out only in combination with drug therapy prescribed by a gynecologist. The doctor makes a diagnosis after examination and examination of the test results.

Symptoms and treatment of chronic cervicitis

Chronic cervicitis occurs due to damage to the genital organs by various bacteria, as well as viruses and fungi. The infectious process can begin with the prolapse of the vagina, or cervix, improper use of birth control and hormonal drugs, promiscuous sex life.

Causes and treatment of atrophic cervicitis

The inflammatory process of cervical epithelial cells, or cervicitis, has quite a few varieties. Among others, atrophic cervicitis is distinguished, which has a number of features, but at the same time develops according to principles common to cervicitis. Among the many causes of the disease, there are specific ones.

Symptoms and treatment of bacterial cervicitis

A fairly common complaint addressed to the patient’s gynecologist is bacterial cervicitis. The disease is infectious in nature, the inflammatory process in this case is localized in the channel of the cervix or in the vagina in the area bordering the cervix. In the first case, the diagnosis.

Symptoms and treatment of viral cervicitis

Cervicitis is accompanied by an inflammatory process in the cervical region. One of the most common types of this pathology is viral cervicitis, sexually transmitted. At the place of localization of the infectious process, the disease is divided into exocervicitis.

Symptoms and treatment of purulent cervicitis

The presence of a purulent mucous cervicitis in a woman makes it possible to suspect urethritis in a partner, which is caused by similar pathogens, but is more difficult to diagnose. Purulent cervicitis is one of the most common sexually transmitted diseases and is the most common cause of inflammatory diseases.

Symptoms and treatment of acute cervicitis

Acute inflammation of the cervix is ​​called acute cervicitis. Of the acute bacterial cervicitis, gonorrheal cervicitis is most common. However, the disease can also be caused by streptococci, enterococci, corynebacteria, mycoplasmas, chlamydia.

The consequence and treatment of cervicitis in pregnancy

Cervicitis during pregnancy can turn out to be a very serious problem for both the woman herself and her baby. The disease significantly increases the risks of various complications: abortion in the early stages, premature onset of labor, intrauterine infection of the fetus.

Cervicitis as a cause of cervical erosion

The cause of the pathology can be staphylococci, streptococci, trichomonads, E. coli, etc. In most cases, cervicitis develops in women of childbearing age. As part of a gynecological examination, diagnoses of cervical erosion and cervicitis can be made.

Abstract of a scientific article in medicine and healthcare, author of a scientific paper - Murakov Stanislav Vyacheslavovi

The current aspects of the diagnosis and treatment of chlamydial cervicitis are analyzed. The possibility of an integrated approach in the treatment of cervicitis of chlamydial etiology is being considered.

The paper analyzes the current approaches for the diagnosis and treatment of chlamydial cervicitis. It considers whether a comprehensive approach can be applied in the therapy of cervical Chlamydia trachomatis infection.

The text of the scientific work on the topic "Modern aspects of the diagnosis and treatment of chlamydial cervicitis"


Road Clinical Hospital OAO RZD,

Sportivny pr., 3, Moscow, 109386, Sportivny Ave, 3, Moscow, 109386,

info @ semashko. com [email protected]

The current aspects of the diagnosis and treatment of chlamydial cervicitis are analyzed. The possibility of an integrated approach in the treatment of cervicitis of chlamydial etiology is being considered.

Key words: chlamydia, chlamydial cervicitis, chlamydial infection, urogenital chlamydia, cervix, diagnosis of chlamydial cervicitis, treatment of chlamydial cervicitis.

The paper analyzes the current approaches for the diagnosis and treatment of chlamydial cervicitis. It considers whether a comprehensive approach can be applied in the therapy of cervical Chlamydia trachomatis infection.

Keywords: chlamydiasis, chlamydial cervicitis, chlamydial infection, urogenital chlamydiasis, cervix, diagnosis of chlamydial cervicitis, treatment of chlamydial cervicitis.

Urogenital chlamydia caused by the human pathogen Chlamydia trachomatis is the most common sexually transmitted infection. Until 1994, in no country in the world, except Sweden, statistical records of patients with chlamydial infection were carried out, however extrapolated data indicate a three-fold increase in the incidence of chlamydia compared with gonorrhea. In various countries, the number of registered patients with urogenital chlamydia increased several times: there was a clear correlation between the level of infection of Chlamydia trachomatis with an age younger than 20-25 years, risky sexual behavior, and the use of oral contraceptives.

Chlamydial infection is one of the most important medical and social problems in healthcare due to its wide distribution and impact on the reproductive health of the population, the main reason for the development of chronic inflammatory processes of the urogenital tract and as a result of secondary infertility in people of both sexes. A persistent chlamydial infection was found to increase the risk of cervical cancer by 17 times. A serious problem is that the symptoms of chlamydial infection, in particular, chlamydial cervicitis, are not specific, including increased contact bleeding of the mucous membrane, intermenstrual bleeding from the genitals, mucopurulent discharge from the cervical canal, and the presence of ectopia.

With this infection, great difficulties arise with the asymptomatic course of the disease. 70% of women with chlamydial cervicitis (according to different authors, from 49 to 93%) have an erased clinical picture or an asymptomatic infection, and only 5-10% of women have acute and subacute inflammatory processes of the genitourinary organs. Chlamydia affects prenatal development

fetus, outcome of labor and the course of the postpartum period. In 40-60% of children born to mothers suffering from chlamydial cervicitis, they exhibit clinical manifestations of chlamydial infection: conjunctivitis, rhinitis, nasopharyngitis, pneumonia. The frequency of infection of pregnant women ranges from 10 to 40%, and with a complicated gynecological history (salpingoophoritis, infertility, miscarriage) increases to 63%.

Based on the topography of the lesion, chlamydial lesions of the lower (cervicitis, urethritis, cystitis, vulvovaginitis) and upper urogenital system are distinguished, as well as extragenital localization of the pathological process.

Chlamydial cervicitis is the most common clinical form of chlamydial infection in women, since C. trachomatis have a pronounced tropism for cylindrical epithelium. In clinical and epidemiological terms, the subjective asymptomatic course of chlamydial cervicitis in 2/3 of infected women is important. Recent evidence suggests that in uncomplicated cervical infections, a significant number of patients have subclinical chlamydial infection of the upper reproductive system.

Diagnosis of chlamydial cervicitis is based primarily on laboratory research methods, taking into account the anamnesis and clinical data. Laboratory identification methods for C. trachomatis: cytological, cultural, serodiagnostics, DNA-specific.

In the cytoscopic method, simultaneously with the search for cytoplasmic Hal-Bershedter-Provachek inclusion cells, the number of leukocytes is taken into account as an indicator of inflammation, as well as additional information about the presence of concomitant bacterial microflora, yeast-like fungi, trichomonads, etc. Material for the study are scrapings from the cervical canal. Cytoscopic

The sky method is widely available, but effective only in acute forms of infection, significantly less effective and informative in chronic forms of the disease. With urogenital chlamydia, the frequency of detection of Provachek bodies in scrapings of the cervical canal does not exceed 10-12%. The presence of these bodies confirms the diagnosis of chlamydia, but their absence does not exclude the presence of infection.

Immunomorphological methods are based on the detection of antigenic substances of chlamydia in the epithelium and other tissues by treatment of drugs with antibodies. The direct immunofluorescence (PIF) method involves the direct detection of chlamydia antigens. Diagnostic informational content of UIF is associated with the fact that with its help not only corpuscular, but also soluble chlamydia antigens are detected. This method does not depend on a possible change in the tinctorial properties of the microorganism during the disease and treatment. The UIF method is the most important screening method for the diagnosis of urogenital chlamydia. Its sensitivity and specificity when using monoclonal antibodies is 65-90 and 85-90%, respectively. An indirect immunofluorescence method is used in cases where there is no FITC conjugate of antichlamydia antibodies.

Enzyme-linked immunosorbent assay methods are based on the detection of a soluble Chlamydia antigen in test samples. The detection of antibodies to the chlamydial lipid polysaccharide antigen of the IgG, IgA, IgM class chlamydia in the blood serum with the determination of their titer allows one to determine the stage of the disease, substantiate the need for antibacterial treatment and evaluate its effectiveness.

Real-time polymerase chain reaction (Real-time PCR) can be used for the qualitative and quantitative determination of C. trachomatis DNA and may be relevant for a prolonged course of chlamydial infection. The disadvantage of molecular biological methods is the high probability of DNA contamination, as a result of which false-positive results may occur. False negative results are also possible due to the presence of various PCR and LCR inhibitors in the samples.

Currently, there is no laboratory method to avoid both false-positive and false-negative results, therefore, a comprehensive laboratory diagnosis is needed to identify the pathogen, determine the stage of the disease, and justify the need for the appointment of antibacterial drugs. The study of the immune status and the reasonable use of immunomodulators will increase the effectiveness of treatment in the long term after infection. In addition, patients with C. trachomatis detected should be screened for other STIs (gonorrhea, trichomoniasis, syphilis), as well as HIV infection and viral hepatitis.

The goal of treatment for chlamydial cervicitis is the elimination of C. trachomatis, the resolution of the clinical symptoms of the disease, and the prevention of severe

complications and prevention of infection of sexual partners and newborns.

When choosing the means and methods of therapy, it is necessary to take into account the fact that only intracellular forms of chlamydia, the reticular bodies, are sensitive to antibiotics. Elementary bodies and persistent forms of chlamydia are not sensitive to antibiotics. Beta-lactam antibiotics, cephalosporins, chloramphenicol, sulfa drugs are not etiotropic and contribute to the transformation of chlamydia into persistent and L-forms. A similar effect is observed when using subtherapeutic doses of antichlamydia antibiotics.

For treatment, antibiotics are used that act on intracellular forms of chlamydia. These properties among antibiotics are best represented in macrolides. For a long time, the main means in the treatment of chlamydia were tetracycline drugs. However, they require a rather long intake, which increases the risk of serious side effects.

Antibiotic monotherapy should be designed for 6-7 cycles of chlamydia development (at least 2 weeks) and should be used with fresh forms of the disease and the presence of clinical manifestations. In chronic and persistent forms of chlamydial cervicitis, etiotropic drugs are prescribed for 3 weeks or more, and targeted immunotherapy is carried out simultaneously: pyrogenal, tacti-vin, thymalin, polyoxidonium, interferon inducers (amiksin, cycloferon, neovir, immunofar, rido-stin, etc. .), roncoleukin. In addition, it is necessary to prescribe funds for systemic enzyme therapy (lidase, trypsin), hepatoprotectors (essentiale, karsil), antioxidants, eubiotics (bifidum bacterin, enterol). Before prescribing immunotropic drugs, an extended immunological examination of the patient is required (including the profile of CD antigens, interferons). For the prevention of candidiasis, nystatin, levorin, ketoconazole are prescribed in the form of oral, ointment or vaginal forms. In addition, physiotherapy is indicated: diathermy, baths with decoctions of herbs.

Thus, the treatment of chlamydial cervicitis includes etiotropic, pathogenetic, eubiotic, immunomodulating therapy, systemic enzyme therapy, antifungal drugs, and in the presence of copious secretions, local antimicrobials are also used.

The drug of choice in the treatment of chlamydial cervicitis is josamycin, a macrolide antibiotic that is rapidly absorbed from the gastrointestinal tract after ingestion. The peak concentration in blood serum is observed approximately 1 hour after taking the drug, and the half-life is about 2 hours. Repeated administration of josamycin allows you to reach the maximum concentration in the blood on the 2nd-4th day. The drug is rapidly absorbed and accumulates in tissues in high concentrations.

The establishment of clinical and microbiological criteria for the cure of chlamydial infection is carried out using:

1. ELISA for IgA after 1.5-2 months. after treatment (recovery: no IgA).

2. ELISA for IgG after 1.5-2 months. after treatment (recovery: titer reduction of 4-8 times).

3. PCR after 1.5-2 months. after treatment (recovery: PCR is negative) 6, 13.

The management of sexual partners of women who are receiving treatment for cervicitis should be the same as for patients who are considered infected or already definitely have an STI. Partners must be registered, examined and treated if there is or suspicion of chlamydial, gonococcal, trichomonas or other STIs. To prevent reinfection, patients and their sexual partners should refrain from sexual intercourse until the end of the course of therapy (within 7 days after the start of therapy with a single dose or throughout the duration of therapy in the case of a 7-day treatment regimen).

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