1
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Mendoza Cediel P, Garcia Teruel D, Viedma Moreno E, Perez Pomata MT. Mycoplasma hominis peritonitis after oocyte donation. BMJ Case Rep 2024; 17:e257835. [PMID: 38627052 PMCID: PMC11029228 DOI: 10.1136/bcr-2023-257835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
We report the case of a young, immunocompetent, non-pregnant woman diagnosed with acute abdomen 3 weeks after an ultrasound-guided transvaginal oocyte retrieval (TVOR). Peritoneal fluid, obtained during exploratory laparoscopy, yielded Mycoplasma hominis as the sole pathogen. The patient's symptoms and signs improved after 24-hour treatment with intravenous clindamycin, ampicillin and gentamycin. Complete resolution was achieved with oral doxycycline for 14 days.
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Affiliation(s)
| | - David Garcia Teruel
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Mostoles, Mostoles, Spain
| | - Esther Viedma Moreno
- Servicio de Microbiología, Instituto de Investigación, Hospital Universitario Doce de Octubre, Madrid, Spain
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2
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Chan JL, Cerón S, Horiuchi SM, Yap JP, Chihuahua EG, Tsan AT, Kamau E, Yang S. Development of a Rapid and High-Throughput Multiplex Real-Time PCR Assay for Mycoplasma hominis and Ureaplasma Species. J Mol Diagn 2023; 25:838-848. [PMID: 37683891 DOI: 10.1016/j.jmoldx.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 06/10/2023] [Accepted: 07/27/2023] [Indexed: 09/10/2023] Open
Abstract
Bacterial commensals of the human genitourinary tract, Mycoplasma hominis and Ureaplasma species (parvum and urealyticum) can be sexually transmitted, and may cause nongonococcal urethritis, pelvic inflammatory disease, and infertility. Mycoplasma hominis and Ureaplasma species may also cause severe invasive infections in immunocompromised patients. Current culture-based methods for Mycoplasma/Ureaplasma identification are costly and laborious, with a turnaround time between 1 and 2 weeks. We developed a high-throughput, real-time multiplex PCR assay for the rapid detection of M. hominis and Ureaplasma species in urine, genital swab, body fluid, and tissue. In total, 282 specimens were tested by PCR and compared with historic culture results; a molecular reference method was used to moderate discrepancies. Overall result agreement was 99% for M. hominis (97% positive percentage agreement and 100% negative percentage agreement) and 96% for Ureaplasma species (96% positive percentage agreement and 97% negative percentage agreement). Specimen stability was validated for up to 7 days at room temperature. This multiplex molecular assay was designed for implementation in a high-complexity clinical microbiology laboratory. With this method, >90 samples can be tested in one run, with a turnaround time of 4 to 5 hours from specimen extraction to reporting of results. This PCR test is also more labor effective and cheaper than the conventional culture-based test, thus improving laboratory efficiency and alleviating labor shortages.
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Affiliation(s)
- June L Chan
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Stacey Cerón
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Stephanie M Horiuchi
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Jewell P Yap
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Erika G Chihuahua
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Allison T Tsan
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Edwin Kamau
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Shangxin Yang
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California.
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3
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Chang SY, Price TK, Beaird OE, Gaynor PT, Schaenman JM, Carlson ME, Kubak BM, Yang S, Multani A. Mycoplasma hominis
infections in solid organ transplant recipients: clinical characteristics, treatment outcomes, and comparison of phenotypic and genotypic susceptibility profiles. Transpl Infect Dis 2022; 24:e13822. [DOI: 10.1111/tid.13822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/25/2022] [Accepted: 02/22/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Sandy Y. Chang
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
- Division of Infectious Diseases Department of Medicine Loma Linda University Loma Linda CA USA
| | - Travis K. Price
- Department of Pathology and Laboratory Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Omer E. Beaird
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Pryce T. Gaynor
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Joanna M. Schaenman
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Margrit E. Carlson
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Bernard M. Kubak
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Shangxin Yang
- Department of Pathology and Laboratory Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Ashrit Multani
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
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4
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Hulme-Jones JP, Gordon DL, Barbara JA, Li JY. Mycoplasma hominis bursitis in a simultaneous pancreas-kidney transplant recipient: case report and literature review. Transpl Infect Dis 2020; 22:e13392. [PMID: 32603519 DOI: 10.1111/tid.13392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/27/2020] [Accepted: 06/09/2020] [Indexed: 11/28/2022]
Abstract
Mycoplasma hominis can be isolated frequently from the genitourinary tract of some healthy individuals. On rare occasions, it acts as a pathogen in immunocompromised patients such as transplant recipients. Here, we describe the case of a 39-year-old man with end-stage kidney disease secondary to diabetic nephropathy who received a simultaneous pancreas-kidney transplant. He developed pancreatitis and arterial thrombosis 2 weeks post-transplant and required a pancreatectomy. His kidney allograft function remained normal. He developed severe left hip pain 2 weeks post-transplant with a trochanteric bursal effusion detected on magnetic resonance imaging. The effusion grew M. hominis. The patient was treated with 100 mg of doxycycline twice daily for 9 months with full resolution of the effusion at 4 months post-treatment. We also review all previously reported M. hominis infections in transplant recipients.
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Affiliation(s)
| | - David L Gordon
- Department of Microbiology and Infectious Disease, Flinders Medical Centre, Adelaide, SA, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jeffrey A Barbara
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.,Department of Renal Medicine, Flinders Medical Centre, Adelaide, SA, Australia
| | - Jordan Y Li
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.,Department of Renal Medicine, Flinders Medical Centre, Adelaide, SA, Australia
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5
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Cannon CA, Corcorran MA, Shaw KW, Montenovo M, Sibulesky L, Reyes JD, Rayhill SC, Larson AM, Kritek PA, Giovanni S, de Castro I, Arora N, Rakita RM. Hyperammonemia syndrome due to Ureaplasma infection after liver-kidney transplant. Transpl Infect Dis 2020; 22:e13298. [PMID: 32306488 DOI: 10.1111/tid.13298] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/11/2020] [Accepted: 04/12/2020] [Indexed: 11/26/2022]
Abstract
Hyperammonemia syndrome, with high levels of ammonia and neurologic dysfunction, is a syndrome with historically high mortality that may occur after solid organ transplantation. Recently, this has been associated with infection due to Ureaplasma, mostly following lung transplantation. We describe the first case of hyperammonemia syndrome due to Ureaplasma infection after liver-kidney transplantation. Our patient rapidly recovered after specific antibiotic treatment. It is important to consider these infections in the differential diagnosis for encephalopathy post-transplant, as these organisms often do not grow using routine culture methods and polymerase chain reaction testing is typically required for their detection. This is particularly critical after liver transplantation, where a number of other etiologies may be considered as a cause of hyperammonemia syndrome.
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Affiliation(s)
- Chase A Cannon
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Maria A Corcorran
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Kathryn W Shaw
- Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Martin Montenovo
- Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Lena Sibulesky
- Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Jorge D Reyes
- Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Stephen C Rayhill
- Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Anne M Larson
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Patricia A Kritek
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Shewit Giovanni
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Iris de Castro
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Nayan Arora
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Robert M Rakita
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
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6
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Gerber L, Gaspert A, Braghetti A, Zwahlen H, Wüthrich R, Zbinden R, Mueller N, Fehr T. Ureaplasma and Mycoplasma in kidney allograft recipients-A case series and review of the literature. Transpl Infect Dis 2018; 20:e12937. [PMID: 29856498 DOI: 10.1111/tid.12937] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 04/10/2018] [Accepted: 04/28/2018] [Indexed: 11/28/2022]
Abstract
Ureaplasma urealyticum and Mycoplasma hominis are common inhabitants of the human genital tract. Increasingly, serious and sometimes fatal infections in immunocompromised hosts have been reported, highlighting their pathogenic potential. We reviewed the clinical impact of positive Ureaplasma spp. and Mycoplasma spp. urine cultures in 10 renal allograft recipients who presented with sterile leukocyturia. Five recipients remained asymptomatic. Five patients were symptomatic with dysuria or pain at the graft site. Three patients developed biopsy-proven acute graft pyelonephritis with graft dysfunction. One of these patients additionally showed a renal abscess as demonstrated by magnetic resonance imaging (MRI). All were successfully treated. A literature search revealed a substantial number of case reports with severe and sometimes fatal Ureaplasma spp. or Mycoplasma spp. infections in immunocompromised patients. Colonization rate is high in renal transplant patients. A subset of patients is at risk for invasive disease.
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Affiliation(s)
- Lukas Gerber
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.,Division of Nephrology, Kantonsspital Aarau, Aarau, Switzerland
| | - Ariana Gaspert
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Antonio Braghetti
- Department of Radiology, Ospedale San Giovanni, Bellinzona, Switzerland
| | - Hugo Zwahlen
- Division of Nephrology, Ospedale San Giovanni, Bellinzona, Switzerland
| | - Rudolf Wüthrich
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Nicolas Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Thomas Fehr
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.,Department of Internal Medicine, Cantonal Hospital Graubuenden, Chur, Switzerland
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7
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Affiliation(s)
- Søren A Ladefoged
- Department of Medical Microbiology and Immunology University of Aarhus, Denmark.,Department of Clinical Biochemistry University Hospital of Aarhus, Denmark
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8
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Ureaplasma urealyticum continuous ambulatory peritoneal dialysis-associated peritonitis diagnosed by 16S rRNA gene PCR. J Clin Microbiol 2010; 48:4310-2. [PMID: 20739488 DOI: 10.1128/jcm.01045-10] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In some patients with peritonitis complicating continuous ambulatory peritoneal dialysis (CAPD), a causative organism is never identified. We report a case of Ureaplasma urealyticum CAPD-associated peritonitis diagnosed by 16S rRNA gene PCR. Ureaplasma may be an underrecognized cause of peritonitis because it cannot be recovered using routine culture methods.
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9
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Cordtz J, Jensen JS. Disseminated Ureaplasma urealyticum infection in a hypo-gammaglobulinaemic renal transplant patient. ACTA ACUST UNITED AC 2009; 38:1114-7. [PMID: 17148091 DOI: 10.1080/00365540600675734] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report of a case of severe disseminated U. urealyticum infection in a 35-y-old kidney transplanted patient with CVID. Routine microbiological tests were negative. Six weeks after admission, abscess material was grown on Mycoplasma culture medium yielding U. urealyticum in high titres. The patient responded promptly to appropriate antibiotics.
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Affiliation(s)
- Joakim Cordtz
- Department of Nephrology, Rigshospitalet, Copenhagen, Denmark.
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10
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Krijnen MR, Hekker T, Algra J, Wuisman PIJM, Van Royen BJ. Mycoplasma hominis deep wound infection after neuromuscular scoliosis surgery: the use of real-time polymerase chain reaction (PCR). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2006; 15 Suppl 5:599-603. [PMID: 16429284 PMCID: PMC1602191 DOI: 10.1007/s00586-005-0055-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2005] [Revised: 11/07/2005] [Accepted: 12/23/2005] [Indexed: 11/05/2022]
Abstract
Mycoplasma hominis is a commensal of the genitourinary tract. It mostly causes infections to associated structures of this system; however, occasionally it is a pathogen in nongenitourinary tract infections. Since, M. hominis strains require special growth conditions and cannot be Gram stained, they may be missed or delay diagnosis. This report describes a deep wound infection caused by M. hominis after neuromuscular scoliosis surgery; M. hominis was recovered by real-time polymerase chain reaction (PCR). An awareness of the role of M. hominis as an extragenital pathogen in musculoskeletal infections, especially in neuromuscular scoliosis, being a high-risk group for postoperative wound infection, it is necessary to identify this pathogen. Real-time PCR for postoperative deep wound infection, in patients with a history of genitourinary infections, decreases the delay in diagnosis and treatment. In these cases rapid real-time PCR on deep cultures should be considered.
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Affiliation(s)
- Matthijs R. Krijnen
- Department of Orthopaedic Surgery, VU University Medical Center, De Boelelaan 1117, P.O. Box 7057, 1081 HV Amsterdam, The Netherlands
| | - Thecla Hekker
- Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, The Netherlands
| | - Johan Algra
- Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul I. J. M. Wuisman
- Department of Orthopaedic Surgery, VU University Medical Center, De Boelelaan 1117, P.O. Box 7057, 1081 HV Amsterdam, The Netherlands
| | - Barend J. Van Royen
- Department of Orthopaedic Surgery, VU University Medical Center, De Boelelaan 1117, P.O. Box 7057, 1081 HV Amsterdam, The Netherlands
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11
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Losada I, Canle D, Moure R, Villanueva R, Bueno J, Sánchez-Galindo A, Ramil C, Gómez M. Mycoplasma hominis infection after liver transplantation in a child. Transplantation 2004; 77:1624-5. [PMID: 15239634 DOI: 10.1097/01.tp.0000116419.48731.cf] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Samra Z, Rosenberg S, Soffer Y. In vitro susceptibility of Mycoplasma hominis clinical isolates to tetracyclines, quinolones and macrolides. Diagn Microbiol Infect Dis 2002; 44:359-61. [PMID: 12543541 DOI: 10.1016/s0732-8893(02)00459-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We tested the in vitro activity of levofloxacin, ciprofloxacin, doxycycline, tetracycline, erythromycin, roxithromycin, clarithromycin and azithromycin against 110 clinical isolates of Mycoplasma hominis. The minimal inhibitory concentrations (MICs) were determined with the Etest. The minimal concentrations at which 90% of the isolates were inhibited (MIC(90)) were 0.064 microg/ml doxycycline and 0.19 microg/ml tetracycline. In 9 isolates (8.1%), the MIC for doxycycline was 4-12 microg/ml. These isolates were also resistant to tetracycline with a MIC of 32-128 microg/ml. No significant difference was found between doxycycline and tetracycline (p = 0.076). Comparison of the two quinolones revealed that the MIC(90) for levofloxacin was 0.19 microg/ml and for ciprofloxacin, 0.5 microg/ml. A significant difference was found between doxycycline/tetracycline and levofloxacin or ciprofloxacin (p = 0.0001), and between levofloxacin and ciprofloxacin (p = 0.001). All the isolates were highly resistant to the macrolides with MIC > or = 256 microg/ml. This finding has important implications for cases in which Mycoplasma infection is suspected and culture and/or in vitro susceptibility tests are not available.
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Affiliation(s)
- Zmira Samra
- Chlamydia and Mycoplasma National Center, Department of Microbiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
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13
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Pigrau C, Almirante B, Gasser I, Pahissa A. Sternotomy infection due to Mycoplasma hominis and Ureaplasma urealyticum. Eur J Clin Microbiol Infect Dis 1995; 14:597-8. [PMID: 7588844 DOI: 10.1007/bf01690731] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Mycoplasma hominis infections outside the urogenital tract are uncommon. An unusual case of sternal infection caused by both Mycoplasma hominis and Ureaplasma urealyticum is described. This is the first report found in the literature of mixed infection due to these microorganisms at this site. The outcome was favourable after drainage of the surgical wound and antibiotic therapy with clindamycin, gentamicin and doxycycline.
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Affiliation(s)
- C Pigrau
- Infectious Diseases Unit, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona, Spain
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