Extra-urogenital infection by Mycoplasma hominis in transplant patients: two case reports and literature review

Sternal wound infection caused by Mycoplasma hominis in an adult patient: a case report and literature review

BACKGROUND

Mycoplasma hominis is a part of the microflora of the urogenital tract; however, extra-urogenital infections due to M. hominis are rare. Herein, we present a case study of a patient who successfully recovered from a sternal wound infection caused by M. hominis.

CASE PRESENTATION

We report a case of sternal wound infection caused by M. hominis following tricuspid valvuloplasty. The patient developed a severe infection despite postoperative antimicrobial therapy. Wound sample cultures grew pinpoint-sized colonies on blood agar plates, which were identified as M. hominis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Based on the results of the antibiotic susceptibility test, effective infection management was achieved using a combination of moxifloxacin and doxycycline.

CONCLUSIONS

The potential role of M. hominis as a causative agent of postoperative infections after thoracotomy may be underestimated. M. hominis should be highly suspected when patients have an indwelling catheter or when perioperative wound samples show numerous leukocytes with no visible bacteria, and are unresponsive to standard empirical treatment for postoperative infections.

Chronic osteomyelitis with pathological fracture induced by Mycoplasma hominis infection: a case report and review of the literature

Mycoplasma hominis, commonly residing in the genitourinary tract, can cause rare extragenital infections, especially in immunocompromised individuals. This report details a case of chronic osteomyelitis with a pathological femur fracture in a 79-year-old woman. Despite a history of bone tuberculosis, the infection was identified as Mycoplasma hominis through culture and mass spectrometry, highlighting the diagnostic challenges due to the organism's lack of a cell wall. This case underscores the necessity for advanced diagnostic methods and awareness of Mycoplasma hominis in non-urogenital infections.

Bloodstream Infection Combined with Thoracic Infection Caused by Mycoplasma hominis: A Case Report and Review of the Literature

Objective

Mycoplasma hominis is usually found in urogenital tract infections and is associated with several extra-genitourinary infections, including septic arthritis, bacteremia, and meningitis. Here, we report a rare case of M. hominis induced bloodstream infection with thoracic inflammation in a surgical patient.

Methods

A 56-year-old male who underwent surgery for multiple pelvic and rib fractures developed fever, pleural effusion, and wound exudation despite receiving prophylactic anti-infection treatment with cefotiam. Then, replacing the broad-spectrum antimicrobial drugs such as biapenem, imipenem, linezolid still had no obvious curative effect. Meanwhile, a total of 4 groups of blood cultures were collected from patients, of which 2 groups reported positive results 2 to 3 days after specimen collection. At the same time, the patient's pleural effusion and wound pus were also cultured, and transparent needle-like small colonies grew on Columbia blood agar plates within 2 to 3 days after inoculation.

Results

The cultured transparent pinpoint-like small colonies were identified as M. hominis by matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16SrRNA sequencing. The results of antibiotic susceptibility testing (AST) showed that M. hominis was susceptible to doxycycline, minocycline, josamycin, sparfloxacin, and spectinomycin but resistant to azithromycin, clarithromycin, norfloxacin, roxithromycin, and ofloxacin. According to the AST results and clinical symptoms, moxifloxacin was selected as targeted therapy for M. hominis infection, and cefoperazone/sulbactam was combined to prevent the infection of other gram-negative bacteria. Finally, the patient was cured successfully.

Conclusion

Although M. hominis bloodstream and thoracic infections are rare, they cannot be ignored. M. hominis is intrinsically resistant to agents that work on bacterial cell wall synthesis used. Fluoroquinolones could be kept as potential active and thus a likely curative factor. When routine empirical anti-infection treatment is ineffective, the pathogen should be identified as early as possible. If necessary, gene sequencing technology should be used for diagnosis and sensitive anti-infection drug treatment should be promptly administered to reduce the risk of bloodstream infections.

Mycoplasma hominis peritonitis after oocyte donation

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.