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.