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Cause of injury
Inflammatory changes in the cervix occur as a result of physical or chemical damage to the cervical mucosa. Inflammatory changes also occurs as result of cervical infection with a variety of microorganisms which may kill the cells directly or indirectly through toxins and enzymes.
Physical or chemical injury
- Child birth
- Abortion
- Douching
- Radiation
- Laser ablation
- Electrocautery
Infectious organisms
- Viruses
- Herpes genitalis, cytomegalovirus, human papillomavirus
- Bacteria
- Streptococci, staphylococci, chlamydial organisms, N gonorrhoea, M.tuberculosis, Actinomyces sp
- Fungal agents
- Candida albicans,
- Protozoa
- Trichomonas vaginalis, schistosoma s
Effects of injury
Injury to the cervical epithelium results in an inflammatory response which is charcterised by:
- Localised damage to the epithelial cells characterised by degenerative changes to the cytoplasm of the cells and coagulative necrosis of the nuclei
- Systemic changes in the underlying stroma (the inflammatory response). These involve:
- hyperaemia of the papillary vessels
- exudation of fluid into the surrounding tissue
- migration of polymorphs to the site of infection or injury
These changes are non specific and occur regardless of the cause of the injury or infection and can be recognised in histological sections of non specific cervicitis.