Content
- General information about the infection
- Urogenital mycoplasmosis
- Respiratory Mycoplasmosis
- Reasons to treat asymptomatic mycoplasmosis
The presence of mycoplasma in the body can be invisible and even safe. However, it should be noted that this infection is essentially a cellular parasite, waiting for a convenient moment for activation. Mycoplasmas are dangerous not only as an independent causative agent of diseases, but also as a catalyst for the development of other pathogens.
General information about the infection
Mycoplasma is a bacterial infection belonging to the class of Mollicutes. It is the smallest microbe known to date. Mycoplasmas are very diverse in shape, therefore they are easily attached to cells of any type (ciliated epithelium of the bronchi, sperm cells, blood cells), actively reproduce and parasitize on the surface and in the intercellular space.The membrane of infection is able to reliably merge with the membrane of the carrier cell, thanks to which the pathogen becomes inaccessible to the immune factors of the body. As a result, intracellular regulatory mechanisms change, the structure and activity of the affected cell is disrupted, for example:
- ciliated epithelium of the lungs, pushing out sputum, becomes inactive;
- erythrocyte membranes (blood cells) disintegrate, hemoglobin is released into the bloodstream. As a result, microcirculation is disturbed, the probability of blood clots increases;
- spermatozoa become inactive due to parasites attached to the tails.
Phagocytes (immune cells), even when mycoplasma is captured, are often unable to digest it, becoming peddlers.
The main types of mycoplasma
In a separate group, mycoplasma was isolated as early as 1898. At first, the infection was described as the causative agent of atypical pneumonia, and later it was found on the mucous membranes of the urinary tract. Mycoplasmataceae is the most fully studied family of mycoplasmas, including 2 genera: Ureaplasma (only 3 species) and Mycoplasma (more than 100 species). A person can theoretically be a “host” for 14 types of mycoplasma infection, but in medical practice, only 6 are found.
Representatives of the genus Ureaplasma of the species urealyticum (mainly detected in males) and the genus Mycoplasma of the species hominis and genitalium inhabit the urogenital tract. Urealyticum and genitalium provoke the occurrence of acute and chronic non-gonococcal urethritis, prostatitis , and pyelonephritis in men . The role of the hominis species in the development of diseases of the urogenital tract has not yet been fully defined.
Mycoplasma pneumoniae colonizes the respiratory tract, causing focal pneumonia, acute respiratory infections, croup, bronchitis, nasopharyngitis, as well as polyarthritis and meningitis.
Mycoplasma incognitus is the cause of the still insufficiently studied infectious process affecting all body systems. The types of penetrans and fermentans are related to the development of AIDS.
Urogenital mycoplasma
According to ICD-10, the code A49.3 has been assigned to urogenital mycoplasmosis. If the provocateur of inflammation is urealyticum type, then ureaplasmosis is diagnosed . Urealyticum is a mixed infection, that is, it realizes its pathogenic properties only under certain conditions: along with other sexually transmitted pathogens. This species (together with hominis) is considered opportunistic and is present in 50% of clinically healthy men. Most doctors prescribe treatment only in cases where the concentration of the pathogen in the test material is more than 104 CFU / ml, since the growth of the colony over a given volume already provokes inflammation.
The genitalium type also enhances the symptoms of urethritis caused by other pathogens, independently causing diseases of the urogenital tract in only 18% of cases.
Transmission of urogenital mycoplasma occurs predominantly during sexual intercourse. In the external environment, the infection quickly dies, so it is difficult to get infected in the pool, through other people’s hygiene items, although there is a chance. The incubation period lasts from 3 days to 5 weeks.
Symptoms
By itself, a urethral mycoplasma infection usually does not manifest itself; it is impossible to diagnose its presence without laboratory analysis. Symptoms mainly occur only with additional pathogens or with a sharp weakening of the immune system. The manifest (pronounced) form of mycoplasmosis in men is manifested by morning insignificant discharge from the urethra, mild itching, pain when urinating, the appearance of a small amount of pus in the urine is possible. With the penetration of mycoplasma into the bladder under favorable conditions, cystitis develops with characteristic signs: frequent urination with cutting.
In some men, the infection spreads to the epididymis, causing their inflammation (epididymitis). As a result, pain occurs in the scrotum, the affected testicle increases in size.
Manifest form can be acute (the duration of symptoms up to 2 months) or chronic . The acute period of urogenital mycoplasmosis may be accompanied by weak clinical manifestations, which is fraught with a gradual overflow into the chronic form with periodic relapses. Such an outcome is dangerous for a man with infertility, inflammation of the seminal vesicles, narrowing of the urethra. Often, mycoplasma penetrates the tissue of the prostate, appealing to the peripheral zone of the gland.
In some cases, the following symptoms occur simultaneously with mycoplasmal urethritis:
- joint pains;
- conjunctivitis;
- fever.
The patient’s condition is similar to the manifestations of Reiter’s syndrome caused by chlamydia.
Diagnostics
The purpose of diagnosis in urogenital mycoplasmosis is not only to identify the infection itself, but also to determine its type, concentration and degree of influence on the body. It is impossible to detect the pathogen in the blood, only antibodies are present: the type of IgA– in the recurrence of chronic mycoplasmosis, the type of IgG– in a previously transferred disease that is not the cause of the current exacerbation.
In addition to blood, a scraping of urethra and urine is given for analysis, and in some cases semen is also required. The resulting material is sown on nutrient medium and examined by PCR (polymerase chain reaction). Only species of urealyticum and hominis can be detected by bacposing, since genitalium does not grow in laboratory conditions. Only a PCR method is suitable for detecting this type. This type of research is the most informative, in contrast to serological reactions (methods of RPIF, ELISA), which provide information only about the presence of the infection itself, but not about its quantity and the clinical process.
The diagnosis of “urogenital mycoplasmosis” is made in cases when, against the background of severe inflammation of the pelvic organs, the genital type of the pathogen is detected or the concentration of any of the types of mycoplasma infection reaches 104COE / ml.
Treatment
Antibiotics related to macrolides have proven themselves well against urogenital mycoplasma: Azithromycin (250 mg2 times a day, 5 days for a course), Josamycin (prescribed 500 mg twice a day for 10 days). Aminoglycosides are also effective: Doxycycline or Unidox Solutab (100 mg taken twice a day with a course of 10 days). European treatment regimens for urogenital mycoplasmosis include fluoroquinolones ( Ofloxacin ). Above is the average dosage, the treatment should be guided by the appointment of a doctor.
To stabilize the immune system are assigned immunomodulators: Cycloferon, Polyoxidonium, Viferon .
Antibiotics are prescribed strictly individually on the basis of an infection sensitivity analysis. Independent use of drugs will cause pathogen resistance.
The positive effect has the use of phytobiotics:
- extracts of garlic, echinacea, feline root;
- decoction of hypericum and chamomile;
- infusion of goldenrod;
- outdoor baths with decoctions of sage, chamomile, calendula.
Herbal medicine can be used as an independent type of therapy (with the approval of the doctor), if the concentration of the pathogen does not exceed 103 CFU / ml. Otherwise, antibiotics are needed.
During treatment should refrain from any type of sexual intercourse, as well as from alcohol. The course lasts an average of 1-2 weeks. The control analysis is given one month after the end of antibiotics. If the disease proceeded with complications, then an ultrasound of the affected organ is done.
Prevention
The most reliable preventive measure is a monogamous relationship with a proven partner, because mycoplasmas are so small that they can penetrate the pores of the latex condom. If casual sex nevertheless occurred, then within 3 hours it is advisable to contact a dermatovenerologist for active prevention. You can also flush the urethra and oral mucosa with chlorhexidine solution.
Respiratory Mycoplasmosis
Mycoplasma infection of the pneumoniae type, which affects the respiratory tract, is transmitted mainly by airborne droplets during close and prolonged contact with an infected person. Transmission is also possible through sexual contact, as this type of mycoplasma is found in female vaginal secretions. The incubation period is from 4 to 25 days.
Infection may be asymptomatic in the body or a mild form of respiratory mycoplasmosis may occur, manifested by nasal congestion and sore throat. But in some cases (mainly when joining a secondary infection) serious complications arise.
Getting on the mucous membranes of the trachea and bronchi, pneumoniae destroys the intercellular bridges, gradually takes root in the bronchial tree, causing acute mycoplasma bronchitis (ICD-10 code J20.0). The contact of pathogen membranes and cells is so strong that pulmonary mucus cannot wash it off, since the activity of the ciliary epithelium is significantly limited.
The main symptoms of mycoplasmal bronchitis are a sharp increase in temperature (up to 40 ° C), fever, headache mainly in the frontal and temporal parts, nasal congestion. Intoxication reaches a maximum by 4-5 days of illness, and after about 6 days relief comes. A low temperature (about 37 ° C) is maintained for 3-4 weeks, characterized by bouts of debilitating dry cough, awkward swallowing, sore throat.
Mycoplasma pneumonia (ICD-10 code J15.7) is associated with a longer incubation period of 15 to 40 days.
Main symptoms:
- repetitive vomiting;
- exhaustion, lack of appetite;
- heat;
- chest pains;
- persistent dry cough (like pertussis), which becomes productive only by the end of 2 weeks.
Simultaneously with the defeat of the respiratory tract, pain often occurs in large joints, lymph nodes increase, a small rash or red spots appear. In complicated cases, when a secondary bacterial infection joins, mycoplasmosis passes into a generalized form, in which the kidneys, liver, and central nervous system are affected, as a result of which nephritis, hepatitis, meningitis develops. In severe course of the disease lung abscess, lung tissue atrophy, insufficiency of the respiratory function is possible. In 1.4% of mycoplasma pneumonia complicated is fatal.
Diagnosis and treatment
Diagnostic measures for suspected respiratory mycoplasmosis consist in taking swabs from the pharynx and nasal passages, as well as samples of outgoing sputum. In some cases, it is necessary to wash out the lung tissue (lavage fluid), pumped out of the lungs with a bronchoscope under general anesthesia. Based on the material obtained, the specific antigen is determined by ELISA, antibodies are detected by PAGE, PCR. If you suspect pneumonia necessarily X-ray examination.
According to the results of laboratory tests prescribed drugs:
- macrolides and azolides: Azithromycin, Josamycin, Midecamycin, Roxithromycin;
- for relieving symptoms: antipyretic and expectorant drugs (Bromhexine, licorice root);
- immunomodulators: Imunofan, Timalin, Derinat, Polyoxidonium;
- multivitamins.
All the time of therapy, you need to drink plenty of liquids, in severe cases, solutions are injected through an IV.
The treatment regimen prescribed by the doctor can be supplemented by popular methods (after consultation).
Simple recipes:
- infusion of medunitsa (10 g per cup of boiling water);
- infusion of herbs: oregano, train, mother-and-stepmother, plantain. Mix raw materials in equal shares, take 4 tbsp. spoon for half a cup of boiling water, to insist 2 hours;
- milk boiled with figs;
- blackberry tea;
- infusion of cornflower flowers: 2 tbsp. spoon for 500 ml of boiling water, insist hour. Take half a cup three times a day.
Pharmacies sell ready-made chest charges that activate the movement of the ciliated epithelium that pushes mucus out.
Inhalation and other thermal procedures should be coordinated with the doctor so as not to provoke the multiplication of the infection.
The course of treatment of mycoplasma pneumonia ranges from 2 weeks to one and a half months. The prognosis is usually favorable. After recovery, immunity is produced, which can last from 5 to 10 years.
Specific prevention of respiratory diseases caused by mycoplasmal infection does not exist. Immunity plays an important role in the mechanism of development and the course of the disease; therefore, measures to strengthen it will help to cope with the pathogen.
Reasons to treat asymptomatic mycoplasmosis
Not all doctors, finding only one mycoplasma in the analysis in the absence of clinical manifestations, prescribe treatment. This microorganism has not yet been fully studied, so many controversial questions remain as to how dangerous it is in an inactive state. There is a so-called carrier state (latent form of mycoplasmosis) in which the infection does not multiply, but is only present in the body at a concentration of less than 103 CFU / ml. However, it may infect other people.
Most experts are inclined to believe that it is necessary to treat mycoplasmosis in any form. It is motivated by the following reasons:
- Mycoplasmas in the body weaken the local immunity, are “accomplices” of many other infections that develop more actively against their background, the likelihood of complications of various diseases increases;
- Mycoplasma is able to attach to the tails of sperm, violating the technique of movement. The number of ugly germ cells increases (spiralization, fluffy tail). The urealyticum type is capable of dissolving the sperm membrane, and also changes the viscosity of the sperm. All this gradually leads to infertility;
- when pathogen membranes and a healthy cell come in contact, individual components may be exchanged, causing the identification of antigens (foreign microorganisms) to break down and the production of antibodies against their own tissues will start, i.e. the autoimmune process will start;
- as far back as 1965, it was found that mycoplasmas are capable of making changes at the level of chromosomes in cells, as a result, the body’s ability to produce antibodies is affected, reproductive function is affected, the probability of oncogenic transformation of cells against the background of mixed viral infections increases.
Considering how much trouble, often imperceptibly, the presence of mycoplasma in the body can bring, it is still worth taking up treatment. Moreover, the process is short and fairly simple.