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Clinical notes
- Normally the cervix is protected from infection by the multilayered stratified epithelium. Invasion by pathogens is unlikely to be successful as long a this epithelium is intact.
- The atrophic cervix or damaged cervix such as that found in a post natal cervix are particularly susceptible to infection
- Infection is commonly acquired through sexual intercourse with an infected partner
- Infection may be endogenous by direct spread to the cervix from the vagina or uterus
- Overgrowth of organisms which are normally commensal in the cervix and vagina (eg candida, actinomycosis) may become pathogenic due to changes in pH, hormonal activity or altered immune response
- The commonest presenting feature of inflammation in the female genital tract is an offensive, irritating discharge.
- Women whose immunological responses are impaired (eg AIDS patients and diabetics) are particularly susceptible to viral, fungal and protozoal infection and M tuberculosis.
- Although some specific infectious agents can be identified in cervical smears, cytology is not a particularly sensitive method of detecting microbiological organisms and should not be used in place of conventional diagnostic methods such as bacterial culture, Gram staining or immunological tests.