Mycoplasmosis incubation period. Mycoplasma in women. Treatment of mycoplasma hominis in men

• M. pneumonia - causes pulmonary (respiratory) mycoplasmosis;
• M. incognitus - causes a generalized form of mycoplasmosis;
• M. hominis - causes the urogenital form of mycoplasmosis;
• M. genitalium - causes the urogenital form of mycoplasmosis;
• U. urealyticum - causes the urogenital form of mycoplasmosis.

The causative agents of the disease are sensitive to antibacterial drugs from the group of macrolides, fluoroquinolones and tetracyclines. They also die outside the human body from boiling, disinfectant solutions and exposure to ultraviolet radiation.

Causes and mechanism of development of mycoplasmosis

Mycoplasmosis is transmitted sexually (genital form), household contact (urogenital form), airborne droplets (pulmonary form) and vertical (from a mother with the urogenital form, causing the pulmonary form in the fetus or child) by routes.

Human mycoplasmosis is divided into respiratory (pulmonary) and urogenital. Each has its own characteristics of course and treatment. Respiratory problems are treated by a general practitioner or pulmonologist. Urogenital - urologist or gynecologist.

A certain type of mycoplasmosis has its own incubation period. Let's consider them separately.

Respiratory mycoplasmosis

It is transmitted by airborne droplets or from mother to fetus through the placenta. It is divided into mycoplasma bronchitis and mycoplasma pneumonia (pneumonia). The first ones are similar in flow to flu or another viral infection, only with a longer course.

The incubation period is 1-2 weeks. In rare cases, it reaches 3-4 weeks. It begins with fever, nasal congestion and severe cough. After the lungs join the process, an even greater increase in temperature occurs, cough becomes with a small amount of sputum, occurs dyspnea. The duration of this variant of mycoplasmosis is about 2-3 months.

In case of severe illness, it is necessary to stay in a hospital. For therapy, antibiotics, antitussives (in the first few days), expectorants, antipyretics and vitamins are used. Antifungal drugs are also used in treatment.

Urogenital mycoplasmosis

Clinical manifestations after exposure to mycoplasma begin to develop after a period of time from 3 days to 3 weeks. In 80% of cases, infection occurs through sexual contact. However, contact is also possible. It can be asymptomatic, acute and chronic. Manifests itself in slight discharge from the vagina or urethra. Also disturbing is the itching of the genitals, pain when urinating, and pain in the lower abdomen. Women may experience menstrual irregularities; men may experience pain in the scrotum and anus.

Chronic mycoplasmosis sooner or later leads to various complications. This is most common for women infertility, constant miscarriages or premature births. In this case, the child becomes ill with a pulmonary form of the disease. Men are most often characterized by infertility. Both sexes may experience pyelonephritis(kidney inflammation), cystitis(inflammation Bladder), arthritis (inflammation of the joints).

The consequences of respiratory mycoplasmosis are bronchiectasis (irreversible dilatation of the bronchi) and pneumosclerosis (replacement of normal lung tissue with connective tissue). These are the most common complications. But when improper treatment More serious consequences are also possible. This encephalitis(inflammation of the brain) or generalized damage (when almost all organs and systems of human organs are included in the disease process).

Prevention of mycoplasmosis

There are no vaccines against mycoplasmosis. Therefore, to prevent the pulmonary form, it is necessary to follow the same methods as for other colds. And to avoid the genital form of the disease, it is necessary to exclude casual sexual relations, especially unprotected ones, carefully examine pregnant women, properly handle gynecological instruments, and provide adequate treatment for patients with mycoplasmosis.

Diagnosis of mycoplasmosis

Diagnosing mycoplasmosis is a rather difficult task. This is explained by the fact that with this disease there are no signs characteristic only of it. They can also occur in a number of other pathologies. But the presence of chronic inflammation of the genitourinary system can prompt the doctor to think about mycoplasmosis, after which the doctor’s thoughts are confirmed or refuted in the laboratory.

Mycoplasmosis does not have symptoms that are characteristic only of this disease. All complaints that a patient may present are also found in other pathologies of the respiratory or genitourinary system. However, the combination of several signs helps to prompt the doctor to the idea of ​​​​the need to examine the patient for mycoplasmosis.

Mycoplasma can affect the human respiratory system (respiratory or pulmonary mycoplasmosis) and the genitourinary system (urogenital mycoplasmosis). Depending on the location of the disease, complaints will differ.

Respiratory mycoplasmosis includes the following symptoms: in the first days from the onset of the disease, a sore throat appears, nasal congestion and severe, paroxysmal dry cough, there is an increase in body temperature to 38°C. After 1-2 weeks, the temperature rises to 39°C, the cough becomes paroxysmal, with a small amount of sputum, sometimes streaked with blood. A strong one appears dyspnea, blue lips. This suggests that the lungs are involved in the process. This condition can last up to three months.

Signs of mycoplasmosis of the genitourinary system can be so mild that the patient does not pay attention to them for a long time. First of all, patients notice slight discharge from the vagina or urethra. Also characteristic features There will be itching in the area of ​​the glans penis and urethra in men and in the area of ​​the vaginal opening in women. There may be pain and discomfort when urinating. If the infection spreads higher throughout the body, then in women it is possible intermenstrual bleeding, irregular menstruation, nagging pain in the lower abdomen. In men, the symptoms of mycoplasmosis are divided according to the affected organs. If the testicles and their appendages are involved in the process, then the above complaints are accompanied by heaviness in the scrotum area and its slight swelling. If the prostate gland is affected, frequent night urination and pressing pain in the lower abdomen or anus occur. Urine becomes cloudy in color, sometimes streaked with pus.

Complications of mycoplasmosis

Considering that the causes of mycoplasmosis are a small microorganism that does not always cause any complaints in the patient, complications of the disease are often possible. These include bronchiectasis (pathological irreversible dilatation of the bronchi), encephalitis(inflammation of the brain), pyelonephritis(kidney inflammation). As well as arthritis (inflammation of the joints), infertility, premature birth, frequent miscarriages. That is why, in order to prevent such serious consequences, it is necessary, at the slightest suspicion of mycoplasmosis, to consult a pulmonologist, gynecologist or urologist (depending on the affected system).

Treatment of mycoplasmosis

Treatment of respiratory mycoplasmosis

For the treatment of respiratory mycoplasmosis, antibacterial drugs are the main ones. The most effective against mycoplasma:

• tetracyclines - tetracycline (750-1000 mg per day, divided into 3 doses), doxycycline (200 mg per day, divided into 2 doses);
• fluoroquinolones - ofloxacin (600 mg per day, divided into 2 doses), ciprofloxacin (1000 mg per day, divided into 2 doses);
• macrolides - sumamed (500 mg once a day or 1 g once a day), erythromycin (2000 mg per day, divided into 4 doses), clarithromycin (1500 mg per day, divided into 3 doses), azithromycin (1 g once or 500 mg 1 time/day).

The duration of treatment can take from 7 days (in mild cases) to 21 days (in severe cases). Antibiotics for mycoplasmosis are selected strictly individually.

Symptomatic drugs are also used to treat pulmonary mycoplasmosis. These are antitussives (Codterpin 1 tablet no more than 4 times a day, Stoptusin 1 tablet in 3 doses) - used in the first few days of illness for painful paroxysmal cough. Expectorants (ambroxol 1 tablet in 3 divided doses, lazolvan 1 tablet in 3 divided doses, ACC 1 sachet in 4 divided doses) - for a painful cough with sputum difficult to clear. Antipyretics (paracetamol 1 tablet in 4 divided doses, nimide 1 tablet in 2-4 divided doses, ibuprofen 1 tablet in 3 divided doses) - when body temperature rises from 38°C. For sore throat - sprays with antiseptics (Yox, Stoptusin, Givalex) or tablets (Decatylene, Strepsils) - every 3-4 hours. For nasal congestion - spray or drops (nazol, noxprey, aquamaris, naphthyzin).

In severe cases, treatment should take place strictly in a hospital setting under the supervision of a physician.

Treatment of urogenital mycoplasmosis

The main drug in the treatment of urogenital mycoplasmosis, as well as respiratory mycoplasmosis, is an antibiotic. The groups and dosages are the same. However, the duration of treatment is from 3 to 7 days. This is due to the milder course of the disease. In addition to this drug, antifungal drugs are used (fluconazole 100 mg, 1 tablet daily for 10 days or 500 mg once after a course of antibacterial drugs). Probiotics to restore microflora (Linex 1 capsule in 3-5 doses, Bifiform 1 capsule in 3-4 doses, Lacidophil 1 capsule in 3-4 doses). To strengthen the immune system, vitamins are used (vitrum, kvadevit, undevit - 1 tablet in 4 doses) and immunostimulants (Laferon 1 tablet in 3 doses, interferon instilled into the nose every 2 hours).

Treatment of mycoplasmosis in women, in addition to all of the above, includes vaginal suppositories with antibiotics (metronidazole, 1 suppository at night for 10 days, Gravagin, 1 suppository at night for 7-10 days).

After completion of therapy, the woman must undergo a follow-up study. To do this, 10 days after the last antibiotic tablet, a female doctor (gynecologist) takes a smear and does a culture. This procedure must be performed three times during each subsequent menstrual cycle. Only if during these three months all the results are negative, the woman can be considered healthy.

Treatment of mycoplasmosis in men adds to general principles ointments or creams containing antibacterial substances (metrogyl, oflocaine - rub into the head of the penis 2-3 times a day for 1-2 weeks). At the end of treatment, treatment is monitored. Using any laboratory test method that is available in a medical institution, a male doctor (andrologist or urologist) checks for the presence of mycoplasma in the body.

Treatment of mycoplasmosis in children

Treatment of mycoplasmosis in children is one of the difficult tasks. The reason for this is the severity of the disease. It is recommended that all children be hospitalized after such a diagnosis is made.

Antibiotics are the basis for eliminating the cause of the disease. If the child is under 12 years old, then macrolides in the form of a suspension or capsule are indicated, and if the condition is extremely severe, then intramuscular or intravenous fluoroquinolones.

The approximate treatment regimen for mycoplasmosis in children includes drugs such as:

• Antibacterial drug - azithromycin (sumamed) - 10 mg/kg body weight;
• Expectorants - Dr. Theis syrup, Dr. MOM syrup - up to 6 years, ½ teaspoon, from 6 to 12 years, 1 teaspoon, from 12 years, 1 tablespoon 4-6 times a day.
• Antipyretics - Nurofen - up to 3 years, 2.5 ml 2 times a day, from 3 to 6, 5 ml 2-3 times a day, from 6 to 12, 7.5 ml 4 times a day, from 12 years, 10 mo 4 times a day day.
• Probiotic - bifiform, 1 capsule 2-3 times a day.
• Immunostimulator - leukocyte interferon instilled into the nose every 2 hours.
• Drink plenty of fluids.

A children's doctor (pediatrician) will prescribe comprehensive treatment depending on the symptoms, condition of the child and his age. Under no circumstances should you self-medicate.

Treatment of mycoplasmosis with folk remedies

Treatment of mycoplasmosis folk remedies can be allowed only for urogenital form, uncomplicated course. Here are a few recipes that are good to use for low-symptomatic or asymptomatic variants:

• Infuse 3 tablespoons of goldenrod herb in 3 cups of boiling water for 45 minutes. Take ½ cup 4-6 times a day for 21 days.
• 15 g of collection (hogweed, wintergreen and wintergreen herbs) pour into 3-4 glasses hot water and leave for 45-50 minutes. Take ½ cup 5 times a day for 21-28 days.
• Pour 2 tablespoons of oak bark and 1 tablespoon of boron uterus into 1 ½ cups of boiling water, leave for 30-45 minutes. Use as a vaginal douche 2 times a day.

Prevention of mycoplasmosis

There is no specific prevention (vaccine) against mycoplasmosis.

For pulmonary mycoplasmosis, you must adhere to the same rules as for other respiratory tract infections (hardening, maintaining immunity, taking vitamins).

Prevention of urogenital mycoplasmosis includes adherence to personal hygiene rules, adequate sterilization of gynecological instruments, and purification of water in public swimming pools. It is also necessary to adequately identify and treat patients with mycoplasmosis. We must not forget about safe sexual intercourse. In addition, women need to undergo a preventive examination by a gynecologist every six months.

Mycoplasmosis in women

The incubation period after contact with mycoplasmas ranges from 4 to 55 days (average 14 days). But due to the fact that most often mycoplasmosis in women occurs in low-symptomatic or asymptomatic forms, it is practically impossible to determine the moment of infection. The ratio of the incidence of mycoplasmosis in men and women is 1:2.

Due to the fact that sexual transmission of infection is the predominant route, women can become infected not only through direct sexual contact, but also through household means - through towels, sheets or gynecological instruments.

Increase the frequency of detection of mycoplasmas in patients and low level social status, use of hormonal contraception instead of condoms, sexual partner with various sexually transmitted diseases.

Mycoplasmosis in women is classified depending on the location of the lesion:

• mycoplasma bartholinitis(damage to specific glands near the entrance to the vagina);
• mycoplasma vaginitis(damage to the vaginal mucosa);
• mycoplasma endometritis(damage to the inner lining of the uterus);
• mycoplasma salpingitis (damage to the fallopian tubes), etc.

Symptoms of mycoplasmosis in women

For convenience, symptoms of mycoplasmosis in women were divided into mycoplasmosis of the external and internal genital organs. External ones include damage to the vagina, urethra, and specific glands at the entrance to the vagina. And the internal ones included damage to the inner lining of the uterus, fallopian tubes and ovaries.

With mycoplasmosis of the internal genital organs, the infection rises from below and affects the uterus, fallopian tubes or ovaries. Symptoms of damage to these organs are pain in the lower abdomen, heavy vaginal discharge, fever, menstrual irregularities, intermenstrual bleeding , infertility and miscarriages.

Diagnosis of mycoplasmosis in women

Several laboratory methods are used to diagnose mycoplasmosis. These include:

The main complications of mycoplasmosis in women include abscess of the gland of the vaginal vestibule (purulent inflammation), inflammation of the bladder and kidneys, infertility, recurrent miscarriages, chronic endometritis(inflammation of the inner lining of the uterus), placental insufficiency (pathology of the placenta, causing a number of diseases in the fetus), intrauterine diseases of the fetus without pathology of the placenta.

Treatment of mycoplasmosis in women

After completion of treatment, it is necessary to undergo a control study of the effectiveness of treatment. To do this, 10 days after taking the last antibiotic tablet, the female doctor (gynecologist) takes a smear and does a culture. This procedure must be performed three times during each subsequent menstrual cycle. Only if during these three months all the results are negative, can the woman be considered recovered from mycoplasmosis.

Mycoplasmosis in men

The incubation period of mycoplasmosis in men ranges from 4 to 55 days (on average 14 days). But due to the fact that most often mycoplasmosis occurs in low-symptomatic or asymptomatic forms, it is almost impossible to determine the moment of infection. Men get sick less often than women. The ratio of the incidence of mycoplasmosis in men and women is 1:2.

Mycoplasmosis is divided according to the location of the lesion:

• mycoplasma urethritis (damage to the urethra);
• mycoplasma prostatitis(prostate lesion);
• mycoplasma orchitis (damage to one or two testicles)
• mycoplasma epididymitis (damage to the epididymis).

Symptoms of mycoplasmosis in men

Mycoplasmosis does not cause characteristic symptoms in men. Most often, everything goes almost unnoticed and the thought of seeing a doctor does not arise. The disease begins with minor discharge from the genitals and unmotivated discomfort. Symptoms of mycoplasmosis in men also include itching and pain in the penis area. In rare cases, there may be painful sensations in the perineum, scrotum and even into the anus.

With mycoplasma urethritis, symptoms include purulent discharge of varying amounts, cloudy urine, a feeling of discomfort in the glans penis, itching or burning throughout the urethra. If this is an acute course of mycoplasmosis, then the signs are more pronounced and this may prompt the man to go to the hospital. But with a chronic course, there are practically no complaints, the patient does not go to the doctor, which can lead to various complications.

Mycoplasma prostatitis occurs in men who already suffer from urethritis, and due to predisposing factors, the infection penetrates into the gland itself. These factors include regularly interrupted or prolonged sexual intercourse, the presence of frequent constipation, drinking alcohol, etc. Patients may notice more frequent urination at night, the appearance of purulent threads in the urine or even cloudiness of the urine. For a long period of time chronic prostatitis there is a decrease in potency.

With mycoplasma epididymitis and orchitis, a man feels slight nagging pain in the scrotum; rarely, slight swelling of the scrotum may occur, which the patient may not notice.

Diagnosis of mycoplasmosis in men

To diagnose mycoplasmosis, some laboratory methods. These are such as:

In case of untimely or incorrect treatment mycoplasmosis in men may cause a number of complications. These include:

• Mycoplasma pyelonephritis(inflammation of the kidney substance);
• Mycoplasma cystitis(cystitis);
• Male infertility(caused by impaired sperm movement or formation);
• Mycoplasma arthritis (inflammation of the joints).

Treatment of mycoplasmosis in men

Treating just one man is not enough. It is necessary that the sexual partner also undergo diagnostics and, if necessary, undergo treatment. Otherwise, re-infection is possible.

Mycoplasmosis in children

Mycoplasmosis in children is a rather serious disease that is caused by mycoplasmas and has a number of clinical signs. The incubation period ranges from 4 days to 3 weeks (depending on the form of the disease). Just like adults, children can be carriers of mycoplasmas or the disease can be asymptomatic. The appearance of clinical signs in these cases is possible after stress or against the background of reduced immunity. Infection can occur in utero (from a sick mother), through household contact (through towels, bed linen, underwear), sexual contact (through sexual perversion, rape) and through airborne droplets (infection occurs quite rarely).

Symptoms of mycoplasmosis in children

Mycoplasmosis in children is divided into clinical forms:

• respiratory - affects the upper respiratory tract;
• pneumonic - affects the lower respiratory tract;
• urogenital - affects the genitourinary system;
• perinatal - affects the fetus from the mother;
• generalized - damage to the entire body, an extremely severe form.

Mycoplasmosis in children, depending on the form, causes the following symptoms:

Respiratory form: From the onset of infection to the development of the clinic, 4 to 7 days pass. Body temperature rises to 38°C, but intoxication (weakness, body aches, headache, drowsiness) no. The upper parts of the respiratory system (larynx, trachea, bronchi) are affected. Rarely, symptoms of obstruction (difficulty breathing in and out) may occur. It flows quite easily. However, if treated incorrectly, complications may occur: the addition of other microorganisms, lymphadenopathy (damage to lymphatic system), cervical lymphadenitis (inflammation of the cervical lymph nodes).

Pneumonic form: from the onset of infection to the development of the clinic, it takes from 1 to 3 weeks. The onset can be either acute or gradual. During acute development, the child’s body temperature rises to 39°C within a week, after which it remains at 37.5-38°C for another 4 weeks. Signs of intoxication are slightly pronounced, the upper and middle respiratory tracts are affected (up to the medium-caliber bronchi), mild dyspnea, the liver and spleen are enlarged, there may be pain in the joints. With a gradual onset, the symptoms of mycoplasmosis in children are more severe. During the week, body temperature fluctuates from 37.5 to 38°C, after which it rises to 39°C and does not drop for a long time. Signs of intoxication are very pronounced, the lower respiratory tract is affected (down to the level of the lungs), severe shortness of breath, lips turn blue. Bilateral pneumonia appears. Characterized by a dry, painful, paroxysmal cough, which after 3-4 weeks of illness becomes wet, a large amount of purulent yellow sputum is discharged, possibly even with blood. Complications of this form of childhood mycoplasmosis may include sinusitis (inflammation of the nasal mucosa), otitis(ear infection), pyelonephritis(kidney inflammation), hepatitis(liver inflammation), DIC syndrome (blood clotting pathology), encephalitis (inflammation of the brain), pulmonary emphysema (increased airiness of the lung tissue).

Urogenital form: incubation period from 3 days to 3 weeks. The symptoms are the same as in adults. Does not occur often, in adolescence. Minor discharge from the genitourinary organs, slight itching, discomfort, possible pain when urinating, nagging pain in the lower abdomen, in guys there is heaviness in the scrotum area. The same methods are used for diagnosis as for men and women. Complications may include cystitis(inflammation of the bladder), pyelonephritis (inflammation of the kidneys), endometritis(inflammation of the uterus), salpingoophoritis (inflammation of the fallopian tubes and ovaries), epididymitis (inflammation of the epididymis), orchitis (inflammation of the testicles), prostatitis(inflammation of the prostate). Long-term consequences include infertility(both male and female), spontaneous miscarriages.

Perinatal form: infection occurs in utero from a mother with mycoplasmosis. The child is born premature, does not meet its developmental stage, has severe respiratory disorders and brain disorders, and pathological jaundice. The immune system is also poorly developed. This is evidenced by the development of thrush and a long-term non-healing umbilical wound. Intrauterine fetal death is also possible.

Generalized form: This mycoplasmosis in a child affects almost the entire body. The process involves the cardiovascular system, nervous, musculoskeletal, and skin. The survival rate in this case is not very high.

Treatment of mycoplasmosis in children

In severe cases, an antibiotic must be added to all of the above drugs. In children, the group that allows the treatment of mycoplasmosis is the group of macrolides (azithromycin, sumamed, vilprafen, clindamycin). The doctor selects the dosage and convenient form of release (capsules, tablets, syrup) individually, depending on the condition and age of the child. Along with antibiotics, it is necessary to take probiotics, which will help restore normal microflora in the body (bifidumbacterin, linex, bifiform). If the signs of intoxication are too strong, then special detoxification solutions are prescribed intravenously in a stream or drip along with diuretics (in an age-specific dosage). Medicines are also needed to improve the condition. immune system(interferon, viferon, cycloferon).

Generalized and perinatal forms of mycoplasmosis are treated only in a hospital, in an intensive care unit.

Treatment of mycoplasmosis in children must be strictly under the supervision of a doctor. Self-medication or non-compliance with the medical treatment regimen can lead to unwanted complications.

Mycoplasmosis during pregnancy

Mycoplasmosis during pregnancy is detected 2-2.5 times more often than without it. And in women suffering from “habitual” abortions, mycoplasma is detected in 25% of cases. This is a serious reason to think about the problem. There is an opinion that mycoplasmosis in pregnant women This often occurs due to changes in hormonal levels, as well as other physiological processes that occur with a woman (for example, the state of the immune system).

The presence of urogenital mycoplasmosis causes a huge risk of premature birth and the birth of a child with extremely low body weight. It is believed that mycoplasmosis during pregnancy is more often caused by Ureaplasma urealyticum than by other species.

Urogenital mycoplasmosis quite often causes postpartum or post-abortion complications, which are severe, accompanied by high fever and can lead to undesirable consequences. Also, mycoplasmosis in pregnant women can penetrate through the amniotic sac, causing inflammatory changes in the fetal membranes and the inner lining of the uterus. These conditions are what cause premature births and early abortions. It is generally accepted that asymptomatic and low-symptomatic variants of the course are more dangerous for a pregnant woman and more often contribute to the development of complications.

A child can become infected from the mother both during pregnancy and during childbirth. The more premature the child was born, the more severe the manifestations of mycoplasmosis will be in him. Mycoplasma is found in the spinal cord and respiratory system.

To prevent such severe consequences for the mother and unborn child, it is necessary to screen pregnant women for genital mycoplasmosis. It is advisable to do this while planning a child.

If a woman comes to the gynecologist with complaints of slight vaginal discharge, and the doctor detects yellowish discharge and symptoms of inflammation of the cervix and vagina in the speculum, then she must be referred for laboratory diagnostics.

Treatment of mycoplasmosis during pregnancy

Treatment of mycoplasmosis during pregnancy should be based on the basic principles:

• it is necessary to prevent the transmission of microorganisms to the fetus and unborn child,
• therapy is prescribed only if mycoplasmas are found in quantities of at least 100 CFU per 1 ml (colony-forming units),
• treatment must be complete and not harm either the fetus or the expectant mother.

Because of most of antibacterial drugs can pass through the placenta and cause fetal malformations, the doctor must carefully weigh the choice of medication. Given the deterioration of the immune system when carrying a child, a woman should take large amounts of vitamins. There are special vitamins for pregnant women, in which the content of all substances is increased by 2-3 times. These are, for example, pregnavite, vitrum prenatal, elevit. But treatment of mycoplasmosis during pregnancy still cannot be done without antibiotics. The safest drugs are those from the macrolide group. They have the least effect on the fetus, do not cause malformations and have the shortest course of administration. Of all the drugs in this group, it is most optimal to prescribe josamycin. It should be taken only from the second trimester of pregnancy (not earlier than 12 weeks). This is explained by the fact that until the 12th week the fetal organs are formed, and after that they only increase in size. Treatment regimen: take 500 mg 3 times a day (7-10 days). Or another option is possible: take azithromycin 1 g once, and then 250 mg for 3 days.

After the course of therapy has been completed and the doctor sees no signs of inflammation in the mirrors, it is necessary to conduct a control study. It is performed 1 month after taking the last antibiotic tablet.

We must not forget that along with the expectant mother, it is imperative to treat her sexual partner. Otherwise everything symptoms of mycoplasmosis may come back again.

Urogenital mycoplasmosis

Urogenital mycoplasmosis is caused by two types of bacteria: Ureaplasma urealyticum and Mycoplasma hominis. Of all the inflammatory lesions of the genitourinary system, mycoplasmosis Lately takes 40-45%. Due to the fact that patients rarely see a doctor and are increasingly self-medicating, or do not pay attention to the signs of the disease at all, advanced forms of the disease with many complications are becoming more common.

The incubation period of genital mycoplasmosis ranges from 3 days to 3 weeks. But due to the fact that the disease is often asymptomatic or low-symptomatic, it is not possible to determine the time of infection. The ratio of the incidence of mycoplasmosis in men and women is 1:2.

The route of transmission of urogenital mycoplasmosis is mainly sexual. However, it is also possible to become infected through household means - through bed linen and towels. Women can also get mycoplasmosis at an appointment with a gynecologist if the instruments are poorly handled (through gynecological speculums, gloves).

Symptoms of urogenital mycoplasmosis

Urogenital infection caused by mycoplasmas is divided into acute, chronic and asymptomatic. Very often, mycoplasmosis is discovered by chance during a routine examination by a gynecologist.

Symptoms of mycoplasmosis in men are slight discharge from the urethra, mild itching inside the canal or on the head of the penis, possible pain when urinating, and a feeling of discomfort in the genital area. Also, when the testicles and their appendages are affected, mild pain and slight swelling of the scrotum occurs. When a genital mycoplasma infection attaches to the prostate, increased frequency of urination at night and mild pressing pain in the anus or lower abdomen are possible.

Symptoms in women are divided into mycoplasmosis of the external and internal genital organs. Signs of damage to external organs include slight itching at the vaginal opening and slight discharge from the urethra or vagina. And if mycoplasma enters the internal genital organs, pain may occur in the lower abdomen, lumbar region or anus. The menstrual cycle is disrupted, possible intermenstrual bleeding. With an advanced form of genital mycoplasmosis in women, “habitual” miscarriages or infertility. Also, if a sick woman still manages to become pregnant, then stillbirth of the fetus or premature birth is possible. In this case, the child has a number of pathologies.

Diagnosis of urogenital mycoplasmosis

In order to correctly diagnose a urogenital infection of the genitourinary system, examination and laboratory research methods are necessary. Upon examination, you can detect inflammatory changes, swelling, redness, erosion, and pain. This will lead the doctor to believe that some kind of microorganism may be present. To clarify, the following methods are used laboratory diagnostics, How:

It is imperative that your sexual partner undergo examination and treatment. Otherwise, re-infection is possible.

Respiratory mycoplasmosis

The source of the disease is a person infected with mycoplasmosis. In the acute course of pulmonary mycoplasmosis, the pathogen is released from the body 10-11 days from the onset of the disease. And in the chronic version, the course reaches 12-13 weeks.

Transmission occurs mainly by airborne droplets, but household transmission is also possible (through a handshake, children's toys, various objects).

After suffering from respiratory mycoplasmosis, immunity is developed that lasts up to 10 years.

The incubation period of the disease is 1-2 weeks.

Symptoms of respiratory mycoplasmosis

Initially, the symptoms of mycoplasmosis resemble flu or other viral infection. There is an increase in body temperature to 37.5-38.5°C, dry, nasal cough, there is a feeling of soreness in the throat, stuffy nose. A little later, after a few days, the infection descends lower into the bronchi. In this regard, the cough intensifies, becomes unbearable and paroxysmal. Sometimes with a small amount of sputum. Subsequently, the lungs become involved in the process, and mycoplasma pneumonia (pneumonia) occurs. The above signs are accompanied by a strong dyspnea, and there may be streaks of blood in the sputum. With adequate and timely treatment, the disease processes subside within 3 weeks to 3 months. Mycoplasmosis in patients with weak immunity is characterized by complications in the form meningitis(inflammation of the membranes of the brain), arthritis (joint damage), nephritis (inflammation of the kidneys). It is also possible to switch to chronic form. In this case, it is necessary to periodically examine the patient for the development of bronchiectasis (pathological and irreversible airiness of the lungs and dilation of the bronchi) and pneumosclerosis (replacement of normal lung tissue with connective, scar tissue).

Diagnosis of respiratory mycoplasmosis

In order to make a diagnosis of pulmonary mycoplasmosis, one x-ray of the lungs and a general blood test (as with other types of pneumonia) is not enough. There are a number of methods for determining the pathogen in a patient:

Treating mycoplasmosis of the respiratory tract is a long and not simple procedure. The main drug is antibiotics. The group of macrolides (erythromycin, azithromycin, sumamed, clarithromycin) is mainly used. If their use is impossible or ineffective, there are reserve antibiotics (tetracyclines or fluoroquinolones). The duration of treatment is much longer than for other infections, reaching 21-25 days. In the first few days of illness, when the cough is still dry and painful, antitussive drugs (codterpine, stoptusin) are used. In the future, expectorants (ambroxol, lazolvan, ACC) are used until the cough stops. At elevated temperatures, it is necessary to take antipyretics (paracetamol, ibuprofen, nimisulide).

Under no circumstances should you self-medicate; treatment must be monitored by a physician.

When infected with Mycoplasma hominis, symptoms do not always appear. This microorganism can live in the urogenital tract for a long time without causing inflammatory reactions.

But at certain moments the population of bacteria increases. As a result, they cause urethritis, cystitis, and inflammation of the internal genital organs in men and women.

Exacerbation of mycoplasmosis occurs against the background of immunodeficiency and antibiotic therapy. This can happen during pregnancy or in case of other sexually transmitted infections.

• First symptoms
  • Symptoms of urethritis
  • Symptoms of cystitis
  • Symptoms in children
• Symptoms of complications
  • Symptoms of joint damage
  • Symptoms of infertility
• Symptoms of HIV

Incubation period of mycoplasma hominis

Mycoplasmas are transmitted through sexual contact. Household transmission has not been proven.

Children can become infected from their mothers in utero or during childbirth.

The most common route of infection is sexual. After this, symptoms of Mycoplasma hominis do not appear immediately. At least 2-3 weeks must pass before inflammatory processes in the urogenital tract occur.

Sometimes it takes much longer for symptoms to appear. Because Mycoplasma hominis is considered an opportunistic bacterium.

Certain conditions are required for pathogenicity to occur. Mycoplasma hominis is often found in the urogenital tract of clinically healthy individuals.

First symptoms

Initial signs usually occur from the urethra. Mycoplasmas colonize the urethra.

The first symptom may be dysuria. This is a complex of symptoms indicating urinary disorders.

It could be:

• faster
• painful
• difficult

Frequent urination is observed due to irritation of the urethral receptors.

And when mycoplasma hominis spreads to the neck of the bladder, strong, uncontrollable urges are possible. The patient walks frequently, but the volume of urine excreted is insignificant.

Pain may be felt as urine passes through the urethra.
This is due to irritation of the damaged mucous membrane of the urethra.

In men, there are cases when, after infection with Mycoplasma hominis, urination becomes difficult. This is due to swelling of the urethra.

In men it is thinner than in women. Therefore, in case of swelling, a sluggish stream of urine is possible.

Mycoplasmas can also infect the prostate. Especially if there are already foci of chronic inflammation.

The result of its swelling can also be difficulty urinating. Occasionally, traces of blood are found in the urine.

Mycoplasma hominis is characterized by discharge from the genitals. They are usually not intense. They often go unnoticed by the patient. Because the discharge is mucous and not purulent.

Women may confuse them with various physiological vaginal discharges. However, they differ in that they have an unpleasant odor.

Appear against the background of an inflammatory process. Combined with other signs of urethritis.

Symptoms of urethritis

The urethra becomes the entry point for infection when infected in men and women. Although in female patients the vaginal mucosa may also become inflamed.

With urethritis, those infected with mycoplasma suffer from the following symptoms:

• pain when urinating
• discharge from the urethra
• redness in the area of ​​the outlet
• pain during sexual intercourse, as a result – refusal of intimate life

At night, discharge accumulates. They can cause the walls of the urethra to stick together. The first urination after a night's sleep may be difficult.

Symptoms of cystitis

Sometimes mycoplasma hominis leads to the development of cystitis.

More often, symptoms of this disease occur in women. Their urethra is much shorter than the male's. Therefore, mycoplasma hominis ascends into the bladder. It causes cystitis.

The symptoms of this disease are as follows:

• pain in the lower abdomen
• the presence of mucus or pus in the urine (threads are detected upon examination)
• frequent urination
• feeling of residual urine in the bladder

There may be a false urge to urinate. They can occur immediately after the next trip to the toilet.

With mycoplasma cystitis, it usually has a mild clinical course. There is no large amount of pus released. There are no signs of intoxication.

Patients do not have an increase in body temperature, no weakness or headache. There is no reflex urinary retention as a result of detrusor spasm. In this way, the symptoms of cystitis due to infection with Mycoplasma hominis differ from nonspecific bacterial inflammation.

Symptoms of colpitis with mycoplasma hominis in women

In women, Mycoplasma hominis can cause inflammation of the vagina. This pathological process is called colpitis. With mycoplasmosis, it can occur in both acute and chronic forms.

A woman complains of itching in the vagina. The external genitalia may also become inflamed at the same time. Discharge appears.

Upon examination, redness of the vaginal mucosa is detected. Small pinpoint hemorrhages are possible.

Sexual intercourse becomes painful. Therefore, women often refuse intimacy. If pain is not felt during sexual intercourse, then it occurs after its completion.

Clinical signs may improve even without treatment. But mycoplasma hominis remains in the body. It can cause re-inflammation of the bladder at any time.

Symptoms of testicular damage in men

Mycoplasma hominis sometimes affects the testicles of men. Typically, such orchiepididymitis occurs subacutely or chronically. They are accompanied by nagging pain in the scrotum.

Painful sensations are often permanent, although they may intensify after:

• physical activity
• sexual intercourse
• mechanical pressure on the scrotum, even slight

Upon palpation, an edematous appendage and testicle are determined.

Swelling is often detected. There may be redness of the skin of the scrotum. Its folds are smoothed out.

Blood may be present in the ejaculate.

Symptoms in children

Children can become infected with mycoplasmosis during sexual intercourse if they begin to intimate life up to 18 years old. In this case, their symptoms are the same as in adult patients. But the difference is that the clinical signs are usually more pronounced.

In children, Mycoplasma hominis rarely causes any symptoms. Much more often, urethritis, cystitis or colpitis occurs in an acute form.

Newborns also suffer from mycoplasmosis. They become infected through the placenta in utero. Transmission of infection during childbirth is also possible.

In children, Mycoplasma hominis can affect various organs. The eyes, kidneys, and lungs can become inflamed. Therefore, mycoplasmosis is very dangerous for a pregnant woman.

Symptoms of complications

The insidiousness of mycoplasmosis is that it is often mild. The disease is either not accompanied by symptoms at all or has minimal clinical manifestations.

The patient does not see a doctor for a long time. The pathology can last for years. As a result, complications arise. Sometimes they are quite heavy.

Mycoplasmas can cause infertility in both sexes. They can provoke Reiter's disease. These are reactive inflammatory processes that mainly affect the joints. But they can also affect other organs.

Symptoms of joint damage

Reactive arthritis is an inflammatory process that affects the joints when the inflammatory focus is localized in another part of the body. It sometimes develops against the background of long-term mycoplasmosis. The risk of pathology increases significantly when a chronic focus of inflammation is localized in the prostate gland of men.

Most often, only one joint becomes inflamed. As a rule, this is a large joint lower limb. Less commonly, the joints of the hands become inflamed: elbow, shoulder.

The duration of reactive arthritis caused by Mycoplasma hominis is on average six months. Moreover, inflammation continues, even if mycoplasmosis has already been cured. After all, it is not caused by the bacteria themselves.

This “raging” immunity provokes joint damage. After the inflammation subsides, it may recur again after some time. This happens in 50% of cases. In 20% of patients, the plantar fascia or Achilles tendon becomes inflamed.

The pathology is manifested by pain when walking.

With mycoplasmosis, reactive inflammatory processes can affect the skin.

Sometimes keratoderma occurs and ulcers appear in the mouth.

In rare cases, inflammation of the kidneys, structures of the cardiovascular system or brain occurs.

Symptoms of infertility

Mycoplasma hominis can cause infertility in both men and women. This becomes possible when the inflammatory process is localized in the internal genital organs.

In women, mycoplasma can cause inflammation of the uterus.

When the functional and basal layer of the endometrium is involved in the pathological process, endometritis occurs.

It can be chronic. In this case, the process of growing the endometrium is disrupted. It becomes thin and does not acquire the necessary three-layer structure a few days after ovulation. Accordingly, the endometrium cannot accept the embryo.

Even if the egg is fertilized and reaches the uterus, it simply dies, since it cannot be implanted into the mucous membrane of the uterus. Very often, mycoplasma hominis, if it is detected in the endometrium, is part of a mixed flora. There are cases where this bacterium caused inflammation of the fallopian tubes.

With a prolonged course of salpingitis, their patency may be impaired. This is fraught with tubal infertility. It develops only when both tubes are affected. If only one of them becomes impassable, pregnancy is possible, but its likelihood is reduced.

Infection of the fallopian tubes with mycoplasma hominis is also dangerous because it increases the risk ectopic pregnancy. If the fertilized egg is attached to the tube, it may subsequently be removed. Moreover, this is far from the worst outcome of a tubal pregnancy.

If it remains undiagnosed, it threatens the woman’s life. After all, the pipe can burst at any moment.

Infertility occurs with mycoplasmosis in men.

When the prostate is damaged, secretion production is disrupted. And it is necessary to maintain the vital activity of male reproductive cells. The quality of sperm deteriorates and pregnancy becomes impossible.

When the testicles become inflamed, spermatogenesis is disrupted.

This is the process of sperm formation. For men it should go continuously. When it is disturbed, the number of sperm in the ejaculate decreases, and the percentage of morphologically irregular forms of germ cells increases.

Sometimes Mycoplasma hominis causes bilateral inflammation of the vas deferens. In this case, obstructive male infertility develops.

Sperm are produced by the testes. But they cannot enter the urethra and, accordingly, the woman’s vagina. Because the “tubes” through which germ cells move are blocked as a result of a long-term inflammatory process.

Mycoplasma hominis without symptoms

Very often, mycoplasma hominis occurs without symptoms.

Therefore, the diagnosis of mycoplasmosis is established only when:

• there is an inflammatory process
• no pathogens other than mycoplasma that could provoke it have been identified

The mere fact of identifying mycoplasmas is not considered an indication for treatment. Many venereologists believe that since there are no symptoms, there is nothing to worry about.

In fact, mycoplasma hominis is dangerous, even if there is no inflammation of the urogenital tract, and here’s why:

• the disease can become active at any time
• any additional infection will be much more severe
• mycoplasma can spread to the internal genital organs
• a carrier of mycoplasma hominis will infect other people
• with mycoplasmosis in women, it often worsens during pregnancy and threatens its normal course

For these reasons, if Mycoplasma hominis is detected, it is better to be treated immediately. You should not wait for symptoms or spontaneous abortion to begin treatment.

When symptoms disappear with treatment

If there are symptoms of mycoplasmosis, then with treatment they disappear quite quickly. The course of therapy itself lasts from 10 to 14 days. But after 3-5 days of antibiotic therapy, a person’s discharge may stop.

His dysuric symptoms and signs of inflammation in the urethra disappear. This does not mean that you need to stop treatment. The course of antibiotics should be completed to the end.

Any infectious disease, including mycoplasmosis, is treated for as many days as the symptoms last, plus another 3-4 days.

Symptoms of HIV

Very often, mycoplasmas are combined with other STDs. Mycoplasmosis can also occur against the background of HIV. If the immunodeficiency virus has not yet caused pronounced immune disorders, then the disease will proceed as usual.

Mycoplasma hominis may not cause symptoms for a long time. Or has minimal clinical manifestations.

But with severe immunodeficiency, the disease progresses rapidly. The mycoplasma population is increasing. It extends to the lower parts of the urogenital tract. Cystitis, salpingitis, orchiepididymitis, and prostatitis develop. Other infections come along.

The risk of complications of mycoplasmosis increases.

Mycoplasma hominis symptoms reappeared after treatment

It happens that a person has undergone treatment for mycoplasma hominis, and the symptoms have disappeared. But time passes and they appear again.

Why is this happening?

The reasons are as follows:

• The patient did not fully recover
• He did not undergo control diagnostics and was not convinced that mycoplasma hominis was no longer in his urogenital tract
• The person became infected again

You can guess the cause by doing a blood test. Detection of class G antibodies will indicate that the infection has not gone away.
Because they are not synthesized immediately after infection.

The production of these immunoglobulins takes a long time. If antibodies G are not detected, but immunoglobulins M are detected, most likely, we are talking about re-infection. In any case, it is necessary to undergo a second course of therapy.

If this is an exacerbation of an old infection, the doctor may change the drug. Especially if the relapse occurred in short time after previous inflammation. If infection recurs, the antibiotic does not need to be changed.

However, before starting treatment, you should make sure that it was Mycoplasma hominis that caused the symptoms again. To do this, it is necessary to be examined not only for mycoplasmosis, but also for other STIs.

You can take the necessary tests and receive treatment in our clinic. Experienced venereologists work here who will help you get rid of any infections of the urogenital tract.

If you suspect Mycoplasma hominis, contact the author of this article, a venereologist in Moscow with many years of experience.

Mycoplasma hominis is one of 16 types of mycoplasmas that can be found in the body. It is classified as conditionally pathogenic, but under certain conditions it can provoke pathology, the treatment of which is carried out on an outpatient basis. Let's consider the causes, signs, and methods of combating the pathogen.

Mycoplasmosis - causes

Mycoplasma in women is always present in the vaginal microflora. Its concentration is low to cause disease. With the deterioration of local immunity and the development of the inflammatory process, there is increased growth and reproduction of this tiny microorganism. The following patients are predisposed to mycoplasmosis:

• women with high sexual activity;
• having concomitant urogenital pathologies – trichomoniasis, gonorrhea;
• pregnant women.

Mycoplasma hominis is less pathogenic than other types. But the microorganism is often found in a smear when other diseases of the genitourinary system are detected: urethritis, cystitis, pyelonephritis. Doctors call such pathologies directly as a provoking agent that triggers the rapid growth of conditionally pathogenic microflora.

How is Mycoplasma hominis transmitted?

Primary infection with mycoplasma occurs during childbirth. During the advancement of the fetus along the birth canal of the mother, who is the carrier of this microorganism, penetration of the pathogen into the urogenital tract of girls is noted. In addition, intrauterine infection through the placenta is also possible (very rare). When considering Mycoplasma hominis and the routes of transmission of the pathogen, doctors put the sexual route in the first place. Unprotected sexual intercourse with a carrier of microorganisms leads to infection. Predisposing factors for this are:

• frequent change of sexual partners;
• promiscuous sexual relations.

Mycoplasma in women - symptoms

Mycoplasmosis in women, the symptoms of which are listed below, has a hidden course. Because of this, women learn about the presence of the disease a certain time after infection. Often, the microorganism provokes other diseases of the urogenital tract, during the diagnosis of which mycoplasmas are detected. These microorganisms often provoke:

• inflammation of the uterus and appendages;
• pyelonephritis.

The immediate symptoms of these pathologies often indicate mycoplasmosis. Mycoplasmosis, the symptoms of which do not appear immediately after infection, is accompanied by copious discharge from the genital tract. This phenomenon causes a burning sensation, which intensifies during urination. Discomfort and unpleasant sensations can also accompany sexual intercourse. A feature of the disease caused by Mycoplasma hominis is the presence of periods of remission - when the symptoms disappear for a while and then reappear.

Mycoplasmosis - incubation period

Mycoplasmosis in women manifests itself after 3-55 days. This long incubation period explains the difficulty of diagnosing the disease in the early stages. Symptoms of the disease are more pronounced in men. Often the pathology is diagnosed during a joint examination of spouses before planning a pregnancy. Obvious symptoms of the disease in women appear only during an exacerbation of inflammatory diseases of the genitourinary system. Some ladies may ignore periodic burning sensations without seeking medical help.

Discharge from mycoplasmosis

Reproduction in the reproductive system of a pathogen such as mycoplasma, the symptoms of the disease are mentioned above, is accompanied by the appearance of light discharge. At the same time, their character may be different. More often it is mucous discharge of a small volume. Their spontaneous disappearance for a short period causes a deceptive feeling of recovery. The appearance of pathological discharge after 2-3 weeks in a larger volume often forces the girl to consult a gynecologist.

Mycoplasma hominis - diagnosis

Diagnosis of pathology is carried out comprehensively. Analysis for mycoplasmosis allows you to identify the pathogen even at low concentrations. A smear is taken from the vagina, cervix and urethra. This study is preceded by an examination of the woman in a gynecological chair, during which the doctor may notice changes in the cervical uterus. These changes directly become the reason for a comprehensive examination of the patient.

Mycoplasma analysis

Sowing for mycoplasma is carried out with the collection of material from the urethra, vagina, and cervix. After collecting the material, it is examined under a microscope and evaluated. An additional method for diagnosing pathology, which helps to identify the pathogen at low concentrations, is PCR. This reaction detects the presence of pathogen DNA in a blood sample, so pathology can be diagnosed even in the absence of clinical manifestations of the disease.

Mycoplasma is normal

A smear for mycoplasma determines the presence of opportunistic microorganisms. However, a small amount of them is allowed and is normal. Because of this, when making a diagnosis, the gynecologist pays attention to the concentration of mycoplasmas in the results of the analysis. The borderline normal state is 104 CFU/ml. When performing PCR, the patient receives a positive result – mycoplasmas are present in the blood (carriage or acute stage of mycoplasmosis) and a negative result – there are no mycoplasmas. This analysis is used as a supplementary analysis.

Mycoplasma - treatment

Mycoplasma in women, the symptoms and treatment of which depend directly on the type of pathogen, is often diagnosed at a late stage. This necessitates long-term therapy. The basis of treatment is antibacterial drugs aimed at suppressing the growth and development of the pathogen. Medicines are selected taking into account sensitivity, so the prescription is carried out according to the results of laboratory tests.

To exclude Mycoplasma hominis, treatment is carried out comprehensively. Both sexual partners must take the course. In addition to antibiotics and physiotherapeutic procedures, the following groups of drugs are used in the treatment of mycoplasmosis:

• immunomodulators;
• antifungal;
• antiprotozoal.

Mycoplasmosis - treatment, drugs

The treatment regimen for mycoplasmosis is determined individually. When prescribing a course, doctors take into account the severity of the disease, its stage, and the presence of concomitant gynecological pathologies. Before treating mycoplasmosis, the type of pathogen is determined. The basis of therapy is tetracycline preparations:

• Tetracycline;

Macrolides are also effective in the fight against mycoplasma, which include:

• Clarithromycin;
• Azithromycin.

Doctors often prescribe fluoroquinolones as alternative antibacterial agents:

• Ciprofloxacin;
• Ofloxacin.

The course of antibiotics lasts 3-7 days. At the same time, antifungal drugs are prescribed to suppress the growth and reproduction of fungal infections, which occurs due to long-term use of antibiotics. In this case the following is prescribed:

• Clotrimazole;
• Nystatin.

At the final stage, to restore and normalize the vaginal microflora, use:

• Vagilak;
• Gynoflor.

Mycoplasmosis - consequences in women

Untimely detection of mycoplasma hominis in women can provoke diseases of the urogenital system. Due to the absence of clear symptoms when infected with Mycoplasma hominis, the pathogen is detected during the diagnosis of an existing disease of the reproductive system. Often, latent mycoplasmosis causes disorders in the reproductive system such as:

• adhesions in the pelvis;
• postpartum endometritis;
• ectopic pregnancy;
• infertility.

The content of the article

A urogenital infection that is associated with other urogenital STIs and can cause post-gonorrheal inflammation.

Etiology of mycoplasmosis

Mycoplasmas- saprophytes, widespread in soil and water, pathogens of human and animal diseases. For humans, Mycoplasma hominis, M.genitalium and its T-species Ureaplasma urealyticum are opportunistic. Diseases of the urogenital tract are caused by the last three types. Ureaplasma urealyticum produces urease, which breaks down urea, unlike the others, which break down arginine. This property allows them to be distinguished from other types of mycoplasmas. Mycoplasmas are pleomorphic microorganisms that, unlike other bacteria, lack a cell membrane. They are covered with a three-layer membrane and, like viruses, are able to multiply in cells and overcome bacterial filters.
There are opposing opinions regarding the role of mycoplasmas in the occurrence of inflammation of the urogenital tract: some scientists believe that mycoplasmas are absolute pathogens that cause urethritis, prostatitis, postpartum endometritis, pyelonephritis, pathology of pregnancy and the fetus, arthritis, and sepsis. Others believe that mycoplasma is an opportunistic microorganism that can cause inflammation in isolated cases, most often together with other pathogenic or opportunistic microorganisms.
The occurrence of mycoplasmas is estimated from 10 to 50%. Ureaplasma is often diagnosed in gonorrhea, trichomoniasis, and also in the presence of gynecological diseases (58%), and only in 4% in clinically healthy people. In accordance with modern ideas It is believed that M. genitalium is a pathogenic microorganism that can cause urethritis in both sexes and cervicitis.
Mycoplasma hominis and Ureaplasma urealyticum are present on the mucous membranes and in the secretions of the urogenital tract in 40-80% of practically healthy people of reproductive age in an amount of less than 104 CFU/ml. Under certain conditions, the pathogenic properties of these microorganisms are realized, as a result of which they can cause urethritis in men and cystitis in women. Mycoplasma hominis and Ureaplasma urealyticum, in association with other pathogenic and/or opportunistic microorganisms, can be involved in the development of various pathological conditions, including bacterial vaginosis, vaginitis, cervicitis, PID, pregnancy complications, postpartum and post-abortion complications.

Pathogenesis of mycoplasmosis

Once on the mucous membranes of the genitourinary tract, microorganisms are adsorbed on the surface of the cells. Mycoplasmas and ureaplasmas cause inflammatory reactions when associated with other pathogenic microorganisms.

Incubation period of mycoplasmosis

In the experiment, urethritis develops within three days after the introduction of pure culture. In practice, the incubation period is not determined.

Mycoplasmosis Clinic

Mycoplasmas can cause acute, chronic or asymptomatic inflammation of the urinary and genital tract. Since this infection is usually associated with other urogenital diseases, their main clinical symptoms similar. In 50% of cases, mycoplasmosis is diagnosed in patients with post-gonorrheal inflammation; gonorrhea causes residual inflammatory phenomena, and can also cause adhesions, a chronic infiltrative process and other complications.
The diagnosis is established in accordance with ICD-X. A topical diagnosis is indicated, specifying the identified infectious agent (for example: urethritis caused by U. urealyticum).

Diagnosis of mycoplasmosis

1. Bacteriological method.
2. Immunofluorescent tests.
3. DNA probe method (GEN PROBE).
4. Polymerase chain reaction(PCR).

Bacteriological method

In practice, bacteriological methods using various certified diagnostics are most often used. Mycoplasmas are simultaneously cultivated in a liquid and solid medium, supplemented with the necessary substance for microbial growth.
There are methods that allow one to simultaneously determine the sensitivity of microorganisms to antibiotics. Urogenital mycoplasmas are diagnosed in scrapings from the mucous membrane of the urethra, the cervical canal, the outer side of the cervix (in pregnant women), as well as in joint fluid, in punctate from the pouch of Douglas and in peritoneal punctate, in centrifugate of urine and sperm. In newborns, bronchial aspirate can be examined.
Receiving material
Correct obtaining of the test material is the most important diagnostic step. If the rules for collecting material are carefully followed, the specificity of the method is 100%. In most cases, the collection and sending of material to the laboratory is carried out by doctors of various specialties or nurses, who must master the technique of this procedure. The technique for collecting material should be standardized to maximally prevent the addition of accompanying flora and correspond to a certain number of colonies to the number of mycoplasmas in the area where the material is obtained. It is important that epithelial cells are present in the sample, since mycoplasmas attach to epithelial cells with the help of special adhesive factors. Before taking the material, the patient should refrain from using topical antibiotics or other substances to disinfect the cervical canal.
In women, material for research is obtained from the cervical canal. The sample should not contain mucus, so first of all you need to thoroughly wipe the canal with a swab. When taking a smear from the urethra, you should also clear its opening of mucus, then scrape the mucous membrane with a special brush. Urine: The sediment from the urine centrifugate is dissolved in sterile saline. Sperm: diluted in sterile saline solution 1:10. Synovial, peritoneal punctate, punctate from the pouch of Douglas: the centrifugate sediment is dissolved in sterile saline.
Principle of the method
The material for research, obtained from the mucous membrane, is placed in a bottle with a liquid nutrient medium - urea or arginine broth. When studying liquid samples, 0.2 ml of the appropriate liquid is placed in the vial. Sowing on agar: before use, the agar must be placed in a thermostat at 37°C for 15 minutes, and then using a pipette, apply 3 drops of broth to the surface of the agar. Inoculation should be carried out without allowing droplets to coalesce. Dry for 5 minutes at room temperature. Then both nutrient media are incubated in a thermostat in an anaerobic or microanaerophilic environment at a temperature of 36-37°C. If inoculation on agar cannot be done immediately, the broth can be used as a transport medium. At room temperature, samples can be stored for 4-5 hours, in the refrigerator at a temperature of +2 to +8°C - 48 hours.
Evaluation of results
Growth results are assessed after 48 hours of incubation in a thermostat, both in liquid medium and on agar, and should take into account the color change in the broth and the number of colonies in the field of view under microscopy. The indicator is expressed in CFU (Colony Forming Units) units: if there is 0-1 colony in the field of view, the result is 103, if 1-5 colonies - 104, if 5-15 colonies - 105, if 15 or more colonies - 106.
The pathogenicity of mycoplasmas is manifested at an indicator of 104. An indicator of 103 should be regarded as the presence of mycoplasmas.

Differential diagnosis of mycoplasmosis

It is necessary to differentiate it from other urogenital infections using laboratory diagnostic methods.

Treatment of mycoplasmosis

Treatment of infection caused by M. genitalium

- Doxycycline 100 mg twice daily for 10 days or
- Azithromycin 500 mg orally on the first day, then 250 mg per day for 4 days.
Treatment of urogenital infectious diseases caused by U. Urealyticum and M. hominis
- Josamycin 500 mg 3 times a day for 10 days or
- Doxycycline 100 mg twice a day for 10 days.
Treatment of pregnant women
Josamycin 500 mg 3 times a day for 10 days.

Mycoplasma is a family of small prokaryotic organisms of the Mollicutes class, which is characterized by the absence of a cell wall. Representatives of this family, which has about 100 species, are divided into:

Mycoplasmas occupy an intermediate position between viruses and bacteria - due to the absence of a cell membrane and microscopic size (100-300 nm), mycoplasma is not visible even with a light microscope, and this brings these microorganisms closer to viruses. At the same time, mycoplasma cells contain DNA and RNA, can grow in a cell-free environment and reproduce autonomously (binary fission or budding), which brings mycoplasma closer to bacteria.

• Mycoplasma, which causes mycoplasmosis;
• Ureaplasma urealyticum (ureaplasma), causing.

Three types of mycoplasmas (Mycoplasma hominis, Mycoplasma genitalium and Mycoplasma pneumoniae), as well as Ureaplasma urealyticum, are currently considered pathogenic for humans.

Mycoplasma was first identified in Pasteur's laboratory by French researchers E. Nocard and E. Rous in 1898 in cows sick with pleuropneumonia. The pathogen was originally named Asterococcus mycoides, but it was later renamed Mycoplasma mycoides. In 1923, the pathogen Mycoplasma agalactica was identified in sheep suffering from infectious agalaxia. These pathogens and later identified microorganisms with similar characteristics were designated PPLO (pleuropneumonia-like organisms) for 20 years.

In 1937, mycoplasma (species M. hominis, M. fermentans and T-strains) was identified in the human urogenital tract.

In 1944, Mycoplasma pneumoniae was isolated from a patient with non-purulent pneumonia, which was initially classified as a virus and was named “Eton's agent.” The mycoplasma nature of Eaton's agent was proven by R. Chanock by cultivating the original formulation on a cell-free medium in 1962. The pathogenicity of this mycoplasma was proven in 1972 by Brunner et al. by infecting volunteers with a pure culture of this microorganism.

The species M. Genitalium was identified later than other species of genital mycoplasmas. In 1981, this type of pathogen was discovered in the urethral discharge of a patient suffering from nongonococcal urethritis.

Mycoplasma, which causes pneumonia, is distributed throughout the world (can be both endemic and epidemic). Mycoplasma pneumonia accounts for up to 15% of all cases of acute pneumonia. In addition, mycoplasma of this species is the causative agent of acute respiratory diseases in 5% of cases. Mycoplasmosis of the respiratory type is more often observed in the cold season.

Mycoplasmosis caused by M. pneumoniae is observed more often in children than in adults (most patients are school-age children).

1. Hominis is detected in approximately 25% of newborn girls. In boys, this pathogen is observed much less frequently. In women, M. Hominis occurs in 20-50% of cases.

The prevalence of M. genitalium is 20.8% in patients with nongonococcal urethritis and 5.9% in clinically healthy people.

When examining patients with chlamydial infection, mycoplasma of this type was detected in 27.7% of cases, while the causative agent of mycoplasmosis was more often detected in patients without chlamydia. M. genitalium is thought to cause 20–35% of all cases of non-chlamydial nongonococcal urethritis.

In 40 independent studies in women considered to be at low risk, the prevalence of M. genitalium was about 2%.

In women at high risk (more than one sexual partner), the prevalence of this type of mycoplasma is 7.8% (in some studies up to 42%). Moreover, the frequency of detection of M. genitalium is associated with the number of sexual partners.

Mycoplasmosis is more common in women, since in men the urogenital type of the disease can resolve on its own.

Forms

Depending on the location of the pathogen and the pathological process developing under its influence, the following are distinguished:

• Respiratory mycoplasmosis, which is an acute anthroponotic infectious and inflammatory disease of the respiratory system. It is provoked by a mycoplasma of the species M. pneumoniae (the influence of other types of mycoplasmas on the development of respiratory diseases has not yet been proven).
• Urogenital mycoplasmosis, which refers to infectious inflammatory diseases of the genitourinary tract. Caused by mycoplasma species M. Hominis and M. Genitalium.
• Generalized mycoplasmosis, in which extra-respiratory mycoplasma lesions are detected. Mycoplasma infection can affect the cardiovascular and musculoskeletal systems, eyes, kidneys, liver, and cause the development of bronchial asthma, polyarthritis, pancreatitis and exanthems. Extra-respiratory organ damage usually occurs due to the generalization of respiratory or urogenital mycoplasmosis.

Depending on the clinical course, mycoplasmosis is divided into:

• spicy;
• subacute;
• sluggish;
• chronic.

Since the presence of mycoplasmas in the body is not always accompanied by symptoms of the disease, carriage of mycoplasmas is also distinguished (with carriage there are no clinical signs of inflammation, mycoplasmas are present in a titer of less than 103 CFU/ml).

Pathogen

Mycoplasmas are anthroponotic infections of humans (the causative agents of the disease can exist in natural conditions only in human body). The amount of genetic information of mycoplasmas is less than that of any other microorganisms known to date.

All types of mycoplasma are different:

• lack of a rigid cell wall;
• cell polymorphism and plasticity;
• osmotic sensitivity;
• resistance (insensitivity) to various chemical agents aimed at suppressing cell wall synthesis (penicillin, etc.).

These microorganisms are gram-negative and are more amenable to Romanovsky-Giemsa staining.

The causative agent of mycoplasmosis is separated from the environment by a cytoplasmic membrane (contains proteins that are located in lipid layers).

Five types of mycoplasma (M. gallisepticum, M. pneumoniae, M. genitalium, M. pulmonis and M. mobile) have “sliding motility” - they are pear-shaped or bottle-shaped and have a specific terminal formation with an adjacent electron-dense zone. These formations serve to determine the direction of movement and take part in the process of adsorption of mycoplasma onto the cell surface.

Most members of the family are chemoorganotrophs and facultative anaerobes. Mycoplasmas require cholesterol contained in the cell membrane to grow. These microorganisms use glucose or arginine as an energy source. Growth occurs at a temperature of 30C.

Pathogens of this genus are demanding on the nutrient medium and cultivation conditions.

The biochemical activity of mycoplasmas is low. The following types are distinguished:

• capable of decomposing glucose, fructose, maltose, glycogen, mannose and starch, forming acid;
• not capable of fermenting carbohydrates, but oxidizing glutamate and lactate.

Urea is not hydrolyzed by members of the genus.

Differ in complexity antigenic structure(phospholipids, glycolipids, polysaccharides and proteins), which have species differences.

The pathogenic properties of mycoplasmas have not been fully studied, so some researchers classify pathogens of this genus as opportunistic microorganisms (they cause a painful condition only in the presence of risk factors), while others classify them as absolute pathogens. It is known that mycoplasmas present in the genital organs at a titer of 102–104 CFU/ml do not cause inflammatory processes.

Transmission routes

The source of infection can be a sick person or a clinically healthy carrier of pathogenic mycoplasma species.

Infection with mycoplasmas of the species M. pneumoniae occurs:

• By airborne droplets. This is the main route of spread of this type of infection, but since mycoplasmas are characterized by low resistance in environment(from 2 to 6 hours in a humid, warm environment), the infection spreads only through close contact (families, closed and semi-closed groups).
• Vertical way. This route of transmission of infection is confirmed by cases of detection of the pathogen in stillborn children. Infection can be either transplacental or during the passage of the birth canal. The disease in this case occurs in a severe form (bilateral pneumonia or generalized forms).
• By everyday means. It is observed extremely rarely due to the instability of mycoplasmas.

Infection with urogenital mycoplasmas occurs:

• Sexually, including orogenital contact. It is the main route of distribution.
• Vertically or during childbirth.
• Hematogenously (microorganisms are transported through the bloodstream to other organs and tissues).
• Contact-household way. This route of infection is unlikely for men and is about 15% likely for women.

Pathogenesis

The mechanism of development of mycoplasmosis of any type includes several stages:

1. The pathogen invades the body and multiplies in the area of ​​the entrance gate. M.pneumoniae affects the mucous membrane of the respiratory tract, multiplying on the surface of cells and in the cells themselves. M.hominis and M.genitalium affect the mucous membrane of the urogenital tract (does not penetrate cells).
2. When mycoplasma accumulates, the pathogen itself and its toxins penetrate the blood. Dissemination (spread of the pathogen) occurs, which can result in direct damage to the heart, central nervous system, joints and other organs. The hemolysin secreted by the pathogen causes the destruction of red blood cells and damages ciliated epithelial cells, which leads to impaired microcirculation and the development of vasculitis and thrombosis. Ammonia, hydrogen peroxide and neurotoxin released by mycoplasmas are toxic to the body.
3. As a result of adhesion (adhesion) of mycoplasmas and target cells, intercellular contacts, cellular metabolism and the structure of cell membranes are disrupted, which leads to dystrophy, metaplasia, death and (desquamation) of epithelial cells. As a result, microcirculation is disrupted, exudation increases, necrosis develops, and in infants the appearance of hyaline membranes is observed (the walls of the alveoli and alveolar ducts are covered with loose or dense eosinophilic masses, which consist of hemoglobin, mucoproteins, nucleoproteins and fibrin). At the early stage of development of serous inflammation, the leading role in the genesis of cell damage belongs to the direct cytodestructive effects of mycoplasmas. At subsequent stages, when the immune component of inflammation attaches, cell damage is observed due to close contact between the cell and mycoplasma. In addition, the affected tissues are infiltrated by macrophages, plasma cells, monocytes, etc. At 5-6 weeks of the disease, the main role belongs to the autoimmune mechanism of inflammation (especially in chronic mycoplasmosis).

Depending on the state of the patient’s immune system, the primary infection may result in recovery or become chronic or latent. If the immune system is in a normal state, the body is cleared of mycoplasmas. In a state of immunodeficiency, mycoplasmosis becomes latent (the pathogen persists in the body for a long time). When the immune system is suppressed, mycoplasmas begin to multiply again. With significant immunodeficiency, the disease becomes chronic course. Inflammatory processes can be localized at the entrance gate or provoke a wide range of diseases (rheumatoid arthritis, bronchial asthma, etc.)

Symptoms

The incubation period of mycoplasma respiratory infection ranges from 4 days to 1 month.

This type of mycoplasmosis can clinically occur as ARVI (pharyngitis, laryngopharyngitis and bronchitis) or atypical pneumonia. The symptoms of mycoplasma acute respiratory diseases do not differ from acute respiratory viral infections caused by other pathogens. Patients experience:

• moderate intoxication;
• chills, weakness;
• headache;
• sore throat and dry cough;
• runny nose;
• slight enlargement of the cervical and submandibular lymph nodes.

The temperature is normal or subfebrile (febrile is rarely observed), conjunctivitis, inflammation of the sclera, and facial hyperemia are possible. Upon examination, hyperemia of the oropharyngeal mucosa is revealed; the membrane of the posterior wall may be granular. Hard breathing and dry wheezing can be heard in the lungs. Catarrhal symptoms disappear after 7-10 days, sometimes recovery is delayed up to 2 weeks. With complications of the disease, otitis media, eustacheitis, myringitis and sinusitis may develop.

Symptoms of acute mycoplasma pneumonia are:

• chills;
• pain in muscles and joints;
• temperature rise to 38-39 °C;
• dry cough, which gradually turns into a wet cough with the separation of mucopurulent, scanty viscous sputum.

Nausea, vomiting and stool upset are sometimes observed. Polymorphic exanthema may appear around the joints.

When listening, harsh breathing, scattered dry rales (a small amount) and moist fine bubbling rales in a limited area are revealed.

When mycoplasma pneumonia ends, bronchiectasis, pneumosclerosis or deforming bronchitis often form.

In children, mycoplasmosis is accompanied by more pronounced manifestations of toxicosis. The child becomes lethargic or restless, there is a lack of appetite, nausea, and vomiting. A transient maculopapular rash may develop. Respiratory failure is mild or absent.

In young children, generalization of the infectious process is possible. In severe form, mycoplasma pneumonia occurs in patients with immunodeficiencies, sickle cell anemia, severe cardiopulmonary diseases and Down syndrome.

Mycoplasma urogenital infection does not have specific symptoms.

Mycoplasmas provoke the development of urethritis, vulvovaginitis, colpitis, cervicitis, metroendometritis, salpingo-oophoritis, epididymitis, prostatitis, and the possible development of cystitis and pyelonephritis.

Mycoplasmosis in women is manifested by scanty transparent discharge, and painful sensations when urinating are possible. When the uterus and appendages are involved in the pathological process, minor nagging pains are observed, which intensify before the onset of menstruation.

In men, mycoplasmosis is manifested in most cases by symptoms of urethritis - burning and itching in the urethra are observed, purulent discharge is possible, urine becomes cloudy, with flakes. Young men may also develop Reiter's syndrome (combined damage to the joints, eyes and urinary tract).

The effect of mycoplasmas on pregnancy

A number of researchers believe that mycoplasmosis in pregnant women is the cause of miscarriage, since in 17% of embryos (spontaneous miscarriage at 6-10 weeks), mycoplasmas were identified among other bacteria and viruses present. At the same time, the question of the significance of mycoplasma as the only cause of spontaneous miscarriages and pathology of pregnancy and fetus has not yet been fully clarified.

Mycoplasmosis during pregnancy can cause infection of the fetus (observed in 5.5-23% of newborns) and the development of generalized mycoplasmosis in the child.

Mycoplasmas can also cause the development of postpartum infectious complications (endometritis, etc.).

Diagnostics

Since the symptoms of mycoplasmosis are not specific, smears from the urethra, vagina and cervical canal are used to diagnose the disease, and a smear from the nasopharynx, sputum and blood are used to diagnose mycoplasma respiratory infection.

To identify the pathogen, use:

• ELISA, which is used to determine the presence of antibodies of classes A, M, G (the accuracy of the method is from 50 to 80%).
• PCR (qualitative and quantitative), which allows the detection of mycoplasma DNA in biological material (99% accuracy).
• A cultural method (inoculation on IST medium), which makes it possible to isolate and identify mycoplasma in clinical material, as well as give a quantitative assessment (100% accuracy). The diagnostic value is a concentration of mycoplasmas of more than 104 CFU per ml, since mycoplasmas can also be present in healthy people.

Since M. genitalium is difficult to culture, diagnosis is usually done by PCR.

Treatment

Treatment is based on the use of antibiotics and antimicrobials. For acute uncomplicated urogenital mycoplasmosis, which:

• Caused by mycoplasma M. hominis, metronidazole and clindamycin are used. Treatment may be local.
• Caused by mycoplasma M. Genitalium, tetracycline drugs (doxycycline) or macrolides (azithromycin) are used.

Treatment of chronic mycoplasmosis requires long-term antibiotic therapy, and several antibiotics are often used. Physiotherapy, immunotherapy, and urethral instillation are also prescribed.

Simultaneous treatment of the sexual partner is also necessary.

Mycoplasmosis in pregnant women is treated with antibiotics only in the third trimester when the active phase of the disease is detected (high titer of mycoplasma).

Treatment of respiratory mycoplasmosis is based on the use of macrolides; in persons over 8 years of age, the use of tetracyclines is possible.

Prevention

Prevention consists of avoiding close contact with patients and using personal protective equipment. There is no specific prevention.