PT - JOURNAL ARTICLE AU - B A Kelly AU - A S Black TI - The inflammatory cervical smear: a study in general practice. DP - 1990 Jun 01 TA - British Journal of General Practice PG - 238--240 VI - 40 IP - 335 4099 - http://bjgp.org/content/40/335/238.short 4100 - http://bjgp.org/content/40/335/238.full SO - Br J Gen Pract1990 Jun 01; 40 AB - This study set out to determine whether the term 'inflammatory' in a cervical smear report implies underlying infection or whether it could be masking cancerous or precancerous changes. Of 826 smears taken in one practice over one year, 42 demonstrated some degree of inflammatory change. Thirty four of these women presented for swabs and almost half (47%) had a microbiologically proven infection. This group was further subdivided, and of those whose smears were reported as simple 'inflammation', just over one third (35%) were infected but of those whose smears were reported as 'severe inflammation', over two thirds were infected (73%). The commonest organisms isolated were Gardnerella vaginalis and Candida albicans. It would therefore appear to be worthwhile to treat patients who report severe inflammation with metronidazole and with anti-fungal pessaries before the smear is repeated. Following treatment two women went on to show dyskaryosis within five months. On colposcopy one of these women was found to have invasive cervical squamous cell carcinoma. It is concluded that whether women with inflammatory smears are treated or not, it is mandatory to repeat the smear, ideally within five months.