Mycoplasma pneumoniae infection with rhabdomyolysis in a child

We report the history of a seven year-old male boy with cough and fever, who developed rhabdomyolysis concomitant with Mycoplasma pneumoniae infection. The association between this organism and the muscular injury is rarely described in paediatric patients. This case then thus emphasizes that even seemingly mild M. pneumoniae airway infections may be complicated by invalidating neuromuscular sequelae.

Hemophagocytic lymphohistiocytosis secondary to Mycoplasma pneumoniae infection without pneumonia

Mycoplasma pneumoniae typically causes respiratory tract infections, including pneumonia. We herein report the case of a 30-year-old Japanese woman with hemophagocytic lymphohistiocytosis (HLH), which is rarely caused by bacteria, secondary to Mycoplasma pneumoniae infection and ensuing hypercytokinemia without pneumonia who was successfully treated with a combination of antibiotics and corticosteroids. Therefore, Mycoplasma pneumoniae infection, which is treatable with antibiotics, should be considered a possible trigger of HLH in patients who present with a viral-like illness without pneumonia.

Fuchs' syndrome (Stevens-Johnson syndrome without skin involvement) in an adult male--a case report and general characteristics of the sporadically diagnosed disease

Fuchs' syndrome (Stevens-Johnson syndrome without skin involvement) is a sporadically diagnosed disease. Most authors consider it to be a pure mucosal variant of Stevens-Johnson syndrome; however, some consider the syndrome a separate entity. The complete absence of cutaneous symptoms may be the reason that not all cases of Fuchs' syndrome are diagnosed and properly classified. The authors describe a case of a 22-year-old patient suffering only from mucosal symptoms, diagnosed as Fuchs' syndrome from the context of the tests performed. A Mycoplasma pneumoniae infection triggered the disease onset. Mycoplasma infection, as a trigger factor of Fuchs' syndrome in adults, has so far been described in only a few isolated cases worldwide.

Chlamydophila pneumoniae and Mycoplasma pneumoniae were not identified in sinus mucosa of patients with chronic rhinosinusitis

Chronic rhinosinusitis is a symptomatic inflammation of the mucosa of the nose and paranasal sinuses lasting for at least 12 weeks. Atypical bacteria Chlamydophila pneumoniae and Mycoplasma pneumoniae are important causes of human respiratory tract infection. Also, they were identified in bronchial respiratory epithelium of patients with chronic obstructive pulmonary disease or asthma. Having in mind the unified airway concept, it is also possible that these bacteria can cause persistent infection of sinus mucosa in patients with chronic rhinosinusitis. Sixty consecutive patients with chronic rhinosinusitis who underwent the functional endoscopic sinus surgery due to medical therapy failure were included in the study. During the operation, sinuses were irrigated with sterile 0.9% NaCl solution and this lavage was immediately aspirated. Aspirates were used for the detection of C. pneumoniae and M. pneumoniae DNA using real-time PCR. C. pneumoniae and M. pneumoniae DNA were not detected in samples analysed. Atypical bacteria C. pneumoniae and M. pneumoniae did not cause persistent infection of sinus mucosa in patients with chronic rhinosinusitis.

[Cycloferon in therapy of hyperplastic laryngitis for decrease of the number of relapses]

The article describes the clinical forms of chronic hyperplastic laryngitis, characterized by persistent and recurrent course, a tendency to the formation of oncological pathology, at the expense of hyperplastic changes in the larynx, leading to a malignancy of the inflammatory process. It was demonstrated the bacterization of larynx by Epstein-Barr virus (EBV) and Mycoplasma in imbalance of system of interferon. Clinical recovery, depending on the clinical form of the disease, using cycloferon, was observed in 57.4% of patients. The inclusion in the complex of the medical support of chronic hyperplastic laryngitis inducer of interferon - cycloferon, provided the reduction of the number of relapses.

[Mycoplasma and Chlamydia as ethiological factors of bronchial asthma in terms of ethnogenesis]

AIM

The study of the prevalence and clinical peculiarities of Mycoplasmosis and Chlamydiosis in patients with different pathogenic forms of bronchial asthma (BA) taking into account ethnicity of a patient.

SUBJECTS AND METHODS

The research covered 239 subjects--both the Europeoids and the Mongoloids in the city of Krasnoyarsk and the town of Kyzyl, all of them being BA patients of different stages, including acute stage and practically healthy. We had determined antigens Mycoplasma pneumoniae, Mycoplasma hominis, Chlamydophila pneumoniae, Chlamydophila psittaci and Chlamydia trachomatis in smears of mucosa of pharynx and antibodies to these antigens in peripheral blood serum.

RESULTS

We found high frequency of Mycoplasmosis and Chlamydiosis in the inhabitants of Eastern Siberia, BA patients with different pathogenic forms as compared to control group. We had determined ethnic peculiarities of specific immune response: IgM to M. pneumoniae was revealed in the Europoids more frequently than in the Mongoloids, but IgM to C. pneumoniae and to C. trachomatis, C. trachomatis antigens had been revealed more often in the Mongoloids than in the Europoids. We accepted as clinical equivalents of Mycoplasmosis and Chlamydiosis diagnostics the following signs: temperature around 37C (subfebrile temperature), non-intensive but stable coughing with scanty mucous and muco-purulent sputum, dyspnea of mixed character.

CONCLUSIONS

Mycoplasma and Chlamydia are meaningful etiologic factors of bronchial asthma. We have found the peculiarities of immune response depending on ethnicity of a patient (ethnic belonging). Clinical markers of Mycoplasmosis and Chlamydiosis should be taken into account in bronchial asthma in order to provide diagnostics timely as well as eradication of infection agents. Because of insufficient knowledge of problem of bronchial asthma related to contamination with Mycoplasma and Chlamydia we put the goal to study the frequency of Mycoplasmosis and Chlamydiosis occurrence in bronchial asthma patients and determine the characteristics clinical course of diseases. We defined antigens Mycoplasma pneumoniae, Mycoplasma hominis, Chlamydophila pneumoniae, Chlamydophila psittaci, Chlamydia trachomatis in smears of oropharynx mucosa and antibodies to them in blood serum.

[Study on changes in cytokines of infertile women with mycoplasma infection and intervention with traditional Chinese medicines]

OBJECTIVE

To investigate the changes in cytokines (IL-1beta, IL-2, TNF-alpha) of peripheral blood and cervical mucous of infertile women with mycoplasma infection and the effect of intervention of traditional Chinese medicines (TCMs).

METHOD

According to the results of culture of mycoplasma from genital tracts, 72 patients with positive mycoplasma were randomly divided into the TCM group (38 cases) and the western medicine group (34 cases). The western medicine group was treated with 0.5 g azithromycin for 3 days and consecutively treated for six courses of treatment, each course of treatment of 4 days. The TCM group were treated with Xiaozhi decoction twice every day for 6 weeks. The IL-1beta, IL-2 and TNF-alpha levels of the peripheral blood and cervical mucous of the two groups were measured by the Ria testing before and after the treatment, and the mycoplasma culture (-) of 32 infertile women as set for control.

RESULT

Before the treatment, TNF-alpha and IL-1beta in levels of the two treatment groups were higher than those of the control group (P < 0.01). In the TCM group, TNF-alpha and IL-1beta levels showed significant differences compared with those before the treatment (P < 0.05) and those of the western group after the treatment (P < 0.01); and IL-2 level didn't have significant change before and after the treatment. The cytokines in peripheral blood of the two treatment groups showed notable difference compared with those of the control group (P < 0.01). In TCM group, IL-2 level had remarkable difference compared with that before the treatment (P < 0.01) and compared with the control group after the treatment (P < 0.01).

CONCLUSION

Cytokines (IL-1beta, IL-2, TNF-alpha) in the peripheral blood and cervical mucous increase in infertile women with the mycoplasma infection, suggesting that TCMs can effectively inhibit the levels of IL-1beta, IL-2, TNF-alpha in the peripheral blood and IL-1beta, TNF-alpha in cervical mucous. It is proved that Xiaozhi decoction can be used to treat infertile women with mycoplasma infection.

[Role of opportunistic infection causative agent in etiology of obstructive bronchitis and prolonged subfebrility in children]

AIM

Determine the role of opportunistic infections causative agents in ethology of obstructive bronchitises and prolonged subfebrilities in children.

MATERIALS AND METHODS

56 children with the diagnosis of obstructive bronchitis and 46 children with the diagnosis of prolonged subfebrility were examined for the presence of herpes, mycoplasma and pneumocystic infections. EIA, IIF, rapid culture method, PCR were used.

RESULTS

The highest number of cases of mixed infection was detected in children with HHV-6 infection. Mixed infection was diagnosed 6 times more frequently in children with obstructive bronchitis and 9 times in children with prolonged subfebrility. The number of children with pneumocystosis in combination with other infections was 2.4 and 2 times higher than with monoinfection; with CMV infection--4 and 2 times; with HSV infection--5 and 4 times; EBV infection--6 and 3.7 times. The only exception was mycoplasmosis detected in children with obstructive bronchitis where the difference between the number of mono and mixed infection cases was insignificant.

CONCLUSION

The data obtained give evidence of wide spread of opportunistic infections.

[Chronic infection urethroprostatit: a new look at old problem]

An open, short-term, prospective, randomized study was conducted. 114 men with chronic urethroprostatitis against chlamydial-mycoplasmal infection, mean age 41,2 +/- 0,4 years, were observed. Follow investigations were performed: PCR, microscopic examination of urethral secretions and semen, transabdominal and transrectal ultrasound examination of prostate, evaluation of indicators of local and systemic immunity. In patients with chronic urethroprostatitis, abnormal urethral secretions were dominated; according to data of ultrasound examination, changes in the prostate were registered in all patients, as well as disturbances in cellular and humoral immunity. Depending on the method of treatment, patients were divided into two groups: Group 1 received an immunomodulator Lavomax and basic treatment: azithromycin at a dose 1.0 g once a week for 3 weeks, Celebrex, physiotherapy (low-intensity laser radiation), prostate massage; and Group 2 received only basic therapy. The control group consisted of 30 healthy men. The most pronounced normalization of cellular immunity (decreased number of leukocytes, reduction of lysosomal activity, increased activity and intensity of phagocytosis, and functional reserve of neutrophils in the ejaculate), as well as normalization of lymphocyte subpopulation composition, immunoregulatory index in the peripheral blood, and levels of IgA, IgG, IL-8, INF-gamma, resolution of clinical symptoms were observed among patients in Group 1. Moreover, the rate of elimination of infectious agents was significantly higher in Group 1. Thus, the use of immunomodulator Lavomax is pathogenetically substantiated treatment for chronic urethroprostatite against chlamydial and mycoplasmal infection, which allows to include Lavomax in a comprehensive treatment of this disease.

Hypogammaglobulinemic patient with polyarthritis mimicking rheumatoid arthritis finally diagnosed as septic arthritis caused by Mycoplasma hominis

Hypogammaglobulinemia is a reduction or absence of immunoglobulin, which may be congenital or associated with immunosuppressive therapy. In addition to infectious diseases, autoimmune diseases have also been reported in patients with hypogammaglobulinemia. A 26-year-old man with hypogammaglobulinemia had multiple joint pain and swelling with erosive changes in the proximal interphalangeal joint of the right middle finger on X-ray film, mimicking rheumatoid arthritis (RA). As polyarthritis remained after immunoglobulin replacement therapy and there was no finding indicating any infection at that time, a diagnosis of RA was made. Prednisolone and etanercept were started. However, his polyarthritis did not improve and he developed meningitis and massive brain ischemia. Finally, a diagnosis of disseminated Mycoplasma hominis infection was made. The differential diagnosis of polyarthritis in patients with hypogammaglobulinemia should strictly exclude Mycoplasma infection by culture with special media or longer anaerobic culture, and molecular methods for mycoplasma.

Mycoplasma genitalium: should we treat and how?

Mycoplasma genitalium is associated with acute and chronic urethritis in men. Existing data on infection in women are limited and inconsistent but suggest that M. genitalium is associated with urethritis, cervicitis, pelvic inflammatory disease, and possibly female infertility. Data are inconclusive regarding the role of M. genitalium in adverse pregnancy outcomes and ectopic pregnancy. Available data suggest that azithromycin is superior to doxycycline in treating M. genitalium infection. However, azithromycin-resistant infections have been reported in 3 continents, and the proportion of azithromycin-resistant M. genitalium infection is unknown. Moxifloxacin is the only drug that currently seems to uniformly eradicate M. genitalium. Detection of M. genitalium is hampered by the absence of a commercially available diagnostic test. Persons with persistent pelvic inflammatory disease or clinically significant persistent urethritis or cervicitis should be tested for M. genitalium, if possible. Infected persons who have not previously received azithromycin should receive that drug. Persons in whom azithromycin therapy fails should be treated with moxifloxicin.

Severe anemia associated with Mycoplasma wenyonii infection in a mature cow

The clinical findings, diagnostic tests, and treatment of clinical anemia in a mature Angus cow infected with the hemoplasma Mycoplasma wenyonii are described. Mycoplasma wenyonii has been previously reported to cause clinical anemia in young or splenectomized cattle; however, infection has not been associated with severe anemia in mature animals.

[Detection and the antibiotic susceptibility analysis of mycoplasma and chlamydia in urogenital tract infections of 327 cases patients with tubal infertility]

OBJECTIVE

To explore the effects of mycoplasma and chlamydia infections on tubal infertilityand to assess the antibiotic susceptibility and resistance of female urogenital, and consequently to guide clinical rational drug use.

METHODS

327 tubal infertility women as infertility group and 286 healthy pregnant women as control group were randomly selected, detected chlamydia trachomatis (CT), ureaplasma urealyticum (UU) and mycoplasma hominis (MH) in cervical secretions and drug resistance of UU and MH.

RESULTS

CT infection rates (14.99%), UU infection rates (23.24%), UU + MH infection rates (29.05%),CT + UU + MH infection rates (9.17%) and total infection rates (88.99%) in infertility group is higher than those (order: 2.80%, 6.99%, 8.39%, 4.55%, 29.02%) in the control group, comparisons of two groups are statistically significant differences (P < 0.05), the susceptibility of UU to roxithromycin (sensitivity is 96.05%), josamycin (sensitivity is 96.05%), tetracycline (sensitivity is 82.89%), vibramycin( sensitivity is 92.11%) and clarithromycin (sensitivity is 96.05%) were relatively high and low to ciprofloxacin and acetyl spiramycin. The susceptibility of MH to josamycin (sensitivity is 95.83%), vibramycin (sensitivity is 91.67%), minocin (sensitivity is 83.33%) and actinospectacin (sensitivity is 75.00%) were relatively high and low to erythromycin, azithromycin, roxithromycin and clarithromycin. UU + MH was only sensitive to josamycin (sensitivity is 90.52%), high resistance (77.89% -91.58%) to erythromycin, azithromycin, acetyl spiramycin, ciprofloxacin, ofloxacin, azithromycin and clarithromycin.

CONCLUSION

Infection of CT, UU, MH and tubal infertility have certain relevance,the rates of CT, UU and MH infection in tubal infertility patients higher than fertile people. For many commonantibacterial drugs, UU, MH and UU + MH has strong resistance, the etiology detection and using adapted antibios should be taken seriously in clinical treatment.

Mycoplasma genitalium: an emerging cause of sexually transmitted disease in women

Mycoplasma genitalium is an emerging sexually transmitted pathogen implicated in urethritis in men and several inflammatory reproductive tract syndromes in women including cervicitis, pelvic inflammatory disease (PID), and infertility. This comprehensive review critically examines epidemiologic studies of M. genitalium infections in women with the goal of assessing the associations with reproductive tract disease and enhancing awareness of this emerging pathogen. Over 27,000 women from 48 published reports have been screened for M. genitalium urogenital infection in high- or low-risk populations worldwide with an overall prevalence of 7.3% and 2.0%, respectively. M. genitalium was present in the general population at rates between those of Chlamydia trachomatis and Neisseria gonorrhoeae. Considering more than 20 studies of lower tract inflammation, M. genitalium has been positively associated with urethritis, vaginal discharge, and microscopic signs of cervicitis and/or mucopurulent cervical discharge in seven of 14 studies. A consistent case definition of cervicitis is lacking and will be required for comprehensive understanding of these associations. Importantly, evidence for M. genitalium PID and infertility are quite convincing and indicate that a significant proportion of upper tract inflammation may be attributed to this elusive pathogen. Collectively, M. genitalium is highly prevalent in high- and low-risk populations, and should be considered an etiologic agent of select reproductive tract disease syndromes in women.

A case of microscopic polyangiitis following mycoplasma infection in a patient with MPO-ANCA positive pulmonary fibrosis

BACKGROUND

Microscopic polyangiitis is a vasculitic disease that may result in a pulmonary renal syndrome. Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis is strongly associated with infection.

CASE SUMMARY

We describe a case of microscopic polyangiitis that developed in a patient with MPO-ANCA positive pulmonary fibrosis following infection with mycoplasma. A renal biopsy was undertaken following the detection of microscopic hematuria during follow-up but no abnormal findings were evident. The MPO-ANCA titer increased following infection with mycoplasma pneumonia and a second renal biopsy demonstrated crescentic glomerulonephritis. The degree of pulmonary fibrosis was unaffected.

DISCUSSION

The present case suggests that the mycoplasma infection triggered the elevation of MPO-ANCA titer and provoked glomerulonephritis in a patient with MPO-ANCA positive IPF. This case indicates the importance of testing for MPO-ANCA at the time of initial diagnosis, performing urinalysis and examining the urine sediment during follow-up and being alert to the potential onset of vasculitis in cases of pulmonary fibrosis.

[Relationship between mycoplasma and chlamydia infection and lesions in the cervical tissue in high-risk HPV-positive patients]

OBJECTIVE

Discussion of the relationship between Mycoplasma and chlamydia infection and lesions in the cervical tissue in high-risk HPV-positive infertile patients with cervical.

METHODS

HPV-negative patients with cervical as the control, retrospective analysis the relationship of Mycoplasma hominis and chlamydia infection, cervical histological graded, and inflammation graded.

RESULTS

The rate of HPV infection in mycoplasma-positive and those with negative mycoplasma has significant difference (P < 0.01), The rate of HPV infection in chlamydia-positive and those with negative chlamydia has no significant difference (P > 0.05). CIN and the incidence of cervical erosion and CIN grade were higher in HPV-positive than HPV-negative group (P < 0.01). The cervical erosion of HPV-positive was no difference in the degree (P > 0.05). Compared with the simple HPV-positive group, CIN and the incidence of severe cervical erosion in mixed infection of Mycoplasma was no difference (P > 0.05).

CONCLUSION

Mycoplasma infection increases the rate of high risk HPV infection, high-risk HPV infection increased cervical pathological damage, Mycoplasma infection might be the factor of persistent infection with high risk HPV, the degree of cervical pathological is the factor of cervical infertility which can not be ignored.

[Identification of Mycoplasma in patients with suspected prostate cancer]

AIM

Tests for Mycoplasma hominis, M. genitalium, Ureaplasma urealyticum in males with suspected prostate cancer.

MATERIALS AND METHODS

Identification of mycoplasms was performed in prostate tissue samples using universal PCR as well as in serum samples of patients with suspected prostate cancer using ELISA for detection of IgG to M. hominis. Two hundred and fifty samples from each lobe of prostate were obtained from 125 patients with suspected prostate cancer by transrectal polyfocal biopsy. Blood samples were drawn from the same patients for ELISA.

RESULTS

Out of 125 patients with suspected prostate cancer, 20.5% were positive for Mycoplasma by PCR. Between studied species, only M. hominis was found in big proportion of analyzed samples. Out of 118 serum samples, 30.5% were positive for IgG to M. hominis in ELISA.

CONCLUSION

Fact of presence of Mycoplasma species in tissue of prostate was established in 20.5% pf patients with suspected prostate cancer. Obtained results show that M. hominis is frequently infects prostate tissue and that this infection was more common in patients with high grade prostatic interstitial neoplasia and prostate cancer than in patients with benign changes of prostate tissue or in persons without prostate disease. This allows to suggest that infection with M. hominis could play an important role in development of cancer.