[Ureaplasma infections in the immunocompromised patient]

The use of immunomodulatory medications is expanding across all fields of medicine. The selective immune deficiencies that arise with their use generate an increased incidence of infections caused by previously lesser-known or generally harmless micro-organisms. Physicians will therefore increasingly encounter patients presenting with unusual infections or their unusual manifestations. Here we present three patients who were treated with various forms of B-cell depleting medication for three very different conditions (granulomatosis with polyangiitis, multiple sclerosis, and tuberous sclerosis complex in their unborn child). In all three cases there was a significant doctor's delay - the diagnosis of a Ureaplasma infection was only made once this was specifically considered, as PCR testing had to be employed. Through this case series we demonstrate that in culture-negative infections in patients receiving therapy that affects the humoral immune response, Ureaplasma infection should be considered and specific diagnostic testing should be used.