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Mycoplasma Genitalium Infection

Essentials

  • Sexually transmitted
  • The bacterium Mycoplasma genitalium has been known for long, but its significance as a pathogen has been confirmed over the recent years.
  • Must be considered in the differential diagnosis of urethritis and cervicitis where the aetiology of symptoms is unclear after chlamydia Chlamydial Urethritis and Cervicitis and gonorrhoea Gonorrhoea have been excluded.
  • Asymptomatic people should not be screened.
  • Encountered in about 5% of patients attending sexually transmitted diseases clinics in the Nordic countries.

Aetiology and clinical picture

  • Mycoplasma genitalium is the smallest known bacteria.
  • Clinical picture resembles that of Chlamydia infection.
  • Asymptomatic infections are common.
  • Mycoplasma causes urethritis in men, cervicitis in women, and it may also cause pelvic inflammatory disease Pelvic Inflammatory Disease (Pid).

Diagnosis

  • Detection of the nucleic acid from a mucous membrane or first-void urine sample http://www.dynamed.com/condition/mycoplasma-and-ureaplasma-genito-urinary-infections#MOLECULAR_TESTING
  • If there is suspicion of a strain resistant to azithromycin, antimicrobial sensitivity testing may be additionally performed.
  • The sample is recommended to be taken only in symptomatic patients when tests for chlamydial and gonococcal infections as well as clean-voided urine have proven negative.
    • particularly of men with unclear urethritis (urethral discharge and burning on urination)
    • of women with lower abdominal pain, burning on urination and increased leucorrhoea
    • if a permanent sexual partner has been diagnosed with Mycoplasma genitalium infection.

Treatment

References

  • Taylor-Robinson D, Jensen JS. Mycoplasma genitalium: from Chrysalis to multicolored butterfly. Clin Microbiol Rev 2011;24(3):498-514. [PubMed]
  • Lis R, Rowhani-Rahbar A, Manhart LE. Mycoplasma genitalium infection and female reproductive tract disease: a meta-analysis. Clin Infect Dis 2015;61(3):418-26. [PubMed]
  • Jensen JS, Cusini M, Gomberg M, et al. 2021 European guideline on the management of Mycoplasma genitalium infections (in press). The International Union against Sexually Transmitted Infections (IUSTI) http://iusti.org/treatment-guidelines/.