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Nongenitourinary infections caused by Mycoplasma hominis in adults
1Department of Bacteriology, Massachusetts General Hospital, Boston 02114.
Abstract:
Eleven new cases of Mycoplasma hominis infection occurring outside the genitourinary tract in adults not in the puerperium were evaluated in relation to the 25 cases previously reported. Cases of bacteremia (n = 14) were commonly associated with trauma or manipulation of the genitourinary tract and were often self-limited. Wound infections (n = 14) followed surgery by 4-14 days in most cases and may have arisen from contamination from the genitourinary or respiratory tract. Joint infections (n = 5) appeared to have resulted from bacteremic seeding in some cases and affected prosthetic joints in particular. Least frequent were central nervous system infections (one case of meningitis and two of brain abscess) and respiratory tract infections (three cases of empyema). The large majority of patients had fever, and infected fluid collections were commonly purulent. The response to therapy was difficult to assess in many cases, but responses to tetracycline, clindamycin, and drainage alone were observed. Identification of M. hominis requires clinical suspicion and alertness on the part of the bacteriology laboratory.
Insights
Mycoplasma hominis infections outside the genitourinary tract are rare but can cause serious conditions like bacteremia and wound infections. Early laboratory detection is crucial for effective treatment.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
Background:
- Mycoplasma hominis is an opportunistic pathogen.
- Infections outside the genitourinary tract are uncommon in non-puerperal adults.
Purpose of the Study:
- To evaluate new cases of Mycoplasma hominis infection outside the genitourinary tract.
- To analyze the clinical presentation, associations, and outcomes of these infections.
Main Methods:
- Retrospective review of 11 new cases.
- Comparison with 25 previously reported cases.
- Analysis of clinical data including infection site, patient history, and treatment response.
Main Results:
- Commonly observed infections included bacteremia (n=14) and wound infections (n=14).
- Joint infections (n=5), CNS infections (n=3), and respiratory infections (n=3) were less frequent.
- Fever was a common symptom; purulent fluid collections were frequent. Treatment responses to tetracycline, clindamycin, and drainage were noted.
Conclusions:
- Mycoplasma hominis infections outside the genitourinary tract require high clinical suspicion.
- Prompt identification by bacteriology laboratories is essential for appropriate patient management.
- Infections are often associated with genitourinary manipulation or surgery.