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transmitted infections, evaluated for pelvic inflammatory disease (PID), and counseled on safe sexual practices CLINICAL PEARLS AND PITFALLS The most common etiology of acute cervicitis is infectious Cervicitis may be diagnosed incidentally in asymptomatic women Sexually active women with cervicitis should be treated empirically for gonorrhea and chlamydia while test results are pending Current Evidence Cervicitis, or inflammation of the cervix, can be acute or chronic in nature The etiology of acute cervicitis is most often an infectious etiology (including Neisseria gonorrhoeae and Chlamydia trachomatis and potentially Mycoplasma genitalium ) Many of the cases of acute cervicitis will not have a specific infectious etiology identified Other etiologies of acute cervicitis include mechanical irritation (e.g., tampon, IUD, sexual intercourse) and chemical irritation (e.g., contraceptive cream, douche) Chronic cervicitis is more often due to a noninfectious etiology If untreated, infections can ascend the genitourinary tract and cause PID which may lead to infertility, chronic pelvic pain, and increased risk of ectopic pregnancy In addition, cervical infections can be transmitted to sexual partners and increases the risk of acquiring HIV infections if exposed Clinical Considerations Clinical Recognition Patients with cervicitis may be asymptomatic Symptomatic patients with cervicitis present with variable and nonspecific symptoms including purulent vaginal discharge, intermenstrual bleeding, postcoital bleeding, and dyspareunia Less frequently, patients will present with urinary symptoms such as dysuria and urinary frequency due to a concomitant urethritis Patients with isolated cervicitis are unlikely to have fever or significant pain The presence of these should signal other conditions such as PID or a herpes simplex virus infection (HSV) Clinical Assessment On physical examination, patients with acute cervicitis will have purulent (or mucopurulent) discharge from the cervix on speculum examination The clinician may also notice that the cervix tends to bleed easily after minor trauma from a