The role of mycoplasmas, ureaplasmas and chlamydiae in the genital tract of women presenting in spontaneous early preterm labour

The genital carriage of Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis was assessed in 72 women admitted to hospital in spontaneous preterm labour and in 26 women requiring preterm delivery for other reasons who formed a control group. Women in preterm labour significantly more often carried ureaplasmas, had large numbers of M. hominis and subsequently developed chorioamnionitis than women in the control group. M. hominis, in particular, occurred more frequently and in large numbers in women who had chorioamnionitis associated with ruptured membranes. Genital carriage of the various micro-organisms appeared not to be associated with fetal growth retardation, although subsequent isolation of ureaplasmas from infants was common. It is suggested that mid-second-trimester vaginal specimens should be cultured on a research basis to establish whether these various micro-organisms identify women at risk of labouring preterm.

Exacerbation of murine respiratory mycoplasmosis by sialodacryoadenitis virus infection in gnotobiotic F344 rats

To test the hypothesis that sialodacryoadenitis virus infection could exacerbate respiratory mycoplasmosis in rats, four groups of 40 7- to 9-week-old gnotobiotic F344/N rats were given two intranasal inoculations 7 days apart: Mycoplasma pulmonis, then sialodacryoadenitis virus; M. pulmonis followed by sterile culture medium; medium initially, then virus; or two doses of medium. Immediately and 3, 5, 10, and 20 days after the second inoculation, the nasal passages, middle ears, larynges, tracheas, lungs, and salivary and lacrimal glands of four rats from each group were prepared for histologic examination, and the respiratory organs from four other rats were collected for quantitative culture of M. pulmonis and sialodacryoadenitis virus. To test statistically the effect of virus infection on mycoplasmosis lesions, we determined indices of the severity of respiratory tract lesions by subjective scoring. In rats given both organisms, indices of nasal and tracheal lesions were significantly (P less than 0.05) greater at 3 days and after than in rats given M. pulmonis alone, and middle ear, laryngeal, and lung lesion indices were significantly greater at 5 days and after. Rats given both mycoplasma and virus had significantly more mycoplasmal colony-forming units in the nasal passages at 3 days and after, and in the larynges, tracheas, and lungs at 10 and 20 days, than rats given only mycoplasma. These results show that sialodacryoadenitis virus infection can exacerbate respiratory mycoplasmosis in rats under experimental conditions; therefore, the virus probably also contributes to expression of naturally occurring mycoplasmosis.

Relationship between Mycoplasma hyosynoviae infection and front limb weakness in Duroc swine

A relationship between degree of Mycoplasma hyosynoviae infection and front limb soundness was examined in 254 Duroc swine. These pigs represented 3 lines of pigs (structurally sound, control, and unsound) from a population divergently selected for 4 generations for front limb soundness. Analysis of sera collected every 4 weeks between 6 and 26 weeks of age yielded complement-fixing antibody titers that were believed to be indicative of the degree of natural infection with M hyosynoviae. Analysis of several variables defined by using titer values failed to reveal significant differences among the 3 selected lines, but trends indicated higher mean and peak titer values for pigs from the unsound line. Correlations between titer variables and front limb soundness variables within genetic groups were low and not significantly different from zero. Correlations between all titer variables were calculated; the correlation between mean titer and peak titer was 0.81 (P less than 0.01), and between mean titer and age at detection of first titer, was -0.56 (P less than 0.01). Pooled heritability estimates were 0.51 +/- 0.28 for mean titer and 0.28 +/- 0.25 for peak titer.

Is there a role for Chlamydia trachomatis and genital mycoplasma in male infertility?

We believe that, without evidence of inflammation (greater than 5 WBC on VB1), there is no indication for routine culture or antibiotic treatment of infertile men. In the presence of active inflammation and positive cultures for chlamydia, treatment with antibiotics is appropriate. However, active inflammation and positive chlamydial cultures were rare findings in our population (2 of 52 and 1 of 52, respectively). Thus, we find no evidence for a role of current asymptomatic mycoplasma or chlamydial infection in male infertility.

[Mycoplasma bovis arthritis in a herd of dairy cattle]

Cases of severe arthritis due to M. bovis in a herd of dairy cattle are reported. M. bovis was also isolated from the mammary tissues and lungs of one of the lame animals at autopsy; this animal did not show any symptoms of respiratory disease or mastitis. M. bovis was detected in milk samples of eight animals in which mastitis was present or absent, though not in any of the animals affected with arthritis. Antibiotic therapy failed to produce permanent results in the lame animals. Ultimately, spontaneous recovery occurred in these cases. M. bovis was no longer isolated following the short period during which lameness was present.

Possible association of mycoplasma and viral respiratory infections with bacterial meningitis

The presence of viral infection was evaluated in 160 children older than three months with bacterial meningitis who were admitted to Children's Medical Center or Parkland Memorial Hospital, Dallas, TX, between October 1979 and March 1982. Results were compared with a single serologic specimen in 138 children without meningitis. A recent history of upper respiratory infection was obtained from 60% of patients, including 10/13 with pneumococcal, 9/16 with meningococcal, and 77/131 with Haemophilus influenzae meningitis. Viral infection was documented by serologic response (23.8%) or viral isolation (13.2%) in 63/160 (40%) of patients with meningitis. There were 23 positive cultures (one patient with both adenovirus and respiratory syncytial virus). Picornaviruses, including two rhinoviruses, were isolated from six of the 24 subjects without meningitis who had viral cultures. There were 69 serologic conversions in meningitis patients, with 12 patients converting to two organisms and four patients converting to three organisms. Viral diagnoses included: adenovirus, 32 children; respiratory syncytial virus, 14; influenza A, 8; influenza B, 4; parainfluenza (1, 2, and 3), 12; picornaviruses, 9; herpes simplex virus, 1; and cytomegalovirus, 1. Additionally, 6/15 seroconverted to Mycoplasma pneumoniae. The acute geometric mean serum antibody titers of meningitis patients were lower than those of the comparison group for adenovirus (3.5 vs. 6.6, p less than or equal to 0.001) and influenza B (1.2 vs. 1.6, p less than or equal to 0.05). Twenty nine of 131 patients with H. influenzae had evidence of recent adenovirus infection. Primary infection with adenoviruses and possibly influenza B or mycoplasma precedes development of bacterial meningitis in some patients and may be a predisposing factor.

Idiopathic cranial polyneuropathy. A fifteen-year experience

Fourteen cases of idiopathic multiple cranial neuropathy seen over fifteen years are reviewed and contrasted with 6 cases of the Tolosa-Hunt syndrome, the closest and better known clinical entity. The syndrome consists of subacute onset of facial pain preceding the onset of cranial nerve palsies. There were 5 men and 9 women aged 21 to 83 years. Eight of the 9 patients treated with corticosteroids showed improvement, with pain usually receding within 48 hours. The cerebrospinal fluid was abnormal in 7 of 12 cases, with either a mild pleocytosis or raised protein content. The cranial nerves most frequently involved were the third and sixth. Motor nerves were affected more than sensory. Corticosteroid therapy appeared to hasten recovery of function. Clinical features are shared by both syndromes, the resulting spectrum of illness probably reflecting diverse aetiologies. Historical perspectives, differential diagnosis and aetiological considerations are discussed so that a coherent prospective clinical approach to the problem can be developed.

Role of genital mycoplasmas in young infants with suspected sepsis

To establish the prevalence of Mycoplasma hominis and Ureaplasma urealyticum in infants up to 3 months of age with suspected sepsis, blood, cerebrospinal fluid, and urine specimens from 203 patients with clinical signs and symptoms of sepsis were cultured for Mycoplasma in addition to routine bacterial cultures. Proved bacterial infections were identified in 24 patients, four of whom had bacteremia. M. hominis and U. urealyticum were not isolated from any of the 191 blood and 199 CSF specimens tested. Of 170 specimens of urine cultured for Mycoplasma, M. hominis was isolated in six patients, U. urealyticum in nine patients, and both organisms in one patient. Twelve of the positive cultures were voided urine specimens, and four were suprapubic bladder aspiration specimens. Genital mycoplasmas appear to be uncommon causes of sepsis or meningitis in young infants. Further studies are required to assess their role in abnormal conditions of the urinary tract in childhood.

Chorionic mycoplasmas and prematurity

In this study, recovery of Ureaplasma urealyticum and Mycoplasma hominis from the freshly exposed chorion following delivery was related to labor length but not to the interval between membrane rupture and delivery, to birth weight or to gestational age.

Mycoplasma bovis infection in gnotobiotic calves and combined infection with respiratory syncytial virus

Mycoplasma bovis was inoculated alone or in combination with respiratory syncytial virus into the respiratory tracts of 12 gnotobiotic calves. Clinical signs ranged from transient pyrexia to protracted fever accompanied by severe lower respiratory signs and in one case, arthritis. Pulmonary lesions included foci of coagulative necrosis surrounded by mononuclear cells and suppurative bronchiolitis with varying degrees of lympho-reticular hyperplasia. No enhancement of lesions occurred in the combined infections of M. bovis and respiratory syncytial virus. M. bovis was identified by immunoperoxidase labelling in lesions of necrosis, especially at interfaces between the lesion and mononuclear cells and in bronchiolar exudates. Organisms were also located in necrotic lesions of joint capsules, in tonsillar crypts, and in liver.

Clinical and microbiological investigation of women with acute salpingitis and their consorts

To determine the microbiological causes of pelvic inflammatory disease, 43 women with acute salpingitis (AS) and 160 controls were studied. Amongst AS women there were significantly higher endocervical isolation rates of Neisseria gonorrhoeae (54% vs 6%), Chlamydia trachomatis (40% vs 13%), Mycoplasma hominis (60% vs 19%), enterobacteria (26% vs 11%) and anaerobic bacteria (58% vs 29%). A polymicrobial pathogenic endocervical flora was present in both gonococcal and non-gonococcal AS. Laparoscopic sampling of the fallopian tubes rarely provided useful microbiological data but did reveal the inaccuracy of clinical diagnosis of AS. Thirty-four male consorts of AS women were investigated; 20 had gonorrhoea and 27 had non-gonococcal urethritis (NGU). A high proportion of infected men had asymptomatic gonorrhoea (35%) and/or asymptomatic NGU (56%). These findings had implications for the management of AS.

Carditis associated with Mycoplasma pneumoniae infection

A 16-year-old boy with acute perimyocarditis had serological evidence of Mycoplasma pneumoniae infection. The endomyocardial biopsy specimen showed grade 2 active lymphocytic myocarditis. A T-cell study suggested a cell-mediated immune process in the pathogenesis of carditis. Mycoplasma pneumoniae needs to be considered as a possible cause of acute carditis, and histological findings may influence management.