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The inflammatory cervical smear: a study in general practice.

B A Kelly, A S Black

    The British Journal of General Practice : the Journal of the Royal College of General Practitioners
    |June 1, 1990
    PubMed
    Summary
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    Cervical smear reports with

    Area of Science:

    • Gynecologic Pathology
    • Cervical Cytology
    • Infectious Disease

    Background:

    • Cervical smear reports indicating 'inflammation' may obscure underlying infections or neoplastic changes.
    • Inflammatory findings in cervical cytology require careful evaluation to differentiate causes.

    Purpose of the Study:

    • To investigate the correlation between 'inflammatory' findings in cervical smears and the presence of infection.
    • To determine if 'inflammatory' changes can mask precancerous or cancerous cervical conditions.

    Main Methods:

    • Analysis of 826 cervical smears over one year.
    • Microbiological investigation of women with inflammatory smear findings.
    • Correlation of smear results with infection status and subsequent cytologic/histologic findings.

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    Main Results:

    • 42 smears showed inflammatory changes; 47% had proven infections.
    • Simple inflammation: 35% infected; Severe inflammation: 73% infected.
    • Gardnerella vaginalis and Candida albicans were common organisms. Two women developed dyskaryosis, one with invasive cervical cancer, after treatment.

    Conclusions:

    • Severe inflammation in cervical smears warrants treatment for infection (e.g., metronidazole, antifungals) before repeat testing.
    • Regardless of treatment, repeat cervical smears are mandatory within five months for inflammatory findings.
    • Inflammatory cervical cytology necessitates follow-up to rule out underlying malignancy.