MYCOPLASMA: types of infection, symptoms and treatment

What is mycoplasma

THE mycoplasma I'm bacteria ubiquitous and very small in size, so much so that they are considered as the smallest cells capable of autonomous life. The family Mycoplasmataceae includes genres within it Mycoplasma is Ureaplasma; in common usage, however, speaking of mycoplasma refers to both genders.

Unlike all other prokaryotes, mycoplasmas they do not possess there cell wall and they also have a cell membrane containing sterols, thus resembling, from this point of view, eukaryotic cells (but not classifiable as such, as they lack other fundamental characteristics).

These bacteria can survive only in the presence of precursors of nucleic acids and sterols, as they are not able to self-synthesize these molecules for their own needs; give rise to bacterial colonies very small, however observable at microscope optical.

Within a human organism, depending on the species, mycoplasma can either remain attached to the outside of the cells or penetrate inside and thus become atypical intracellular bacteria. These mechanisms are necessary for the bacterium for its survival and replication, and once the bacterial colony thus formed manages to invade the tissues it causes direct damage (death of the affected cells) and an activation of the inflammatory defense mechanism.

The bacteria of medical interest belonging to the mycoplasma family are essentially Mycoplasma pneumoniae, Ureaplasma urealyticum, Mycoplasma hominis is Mycoplasma genitalium, of which the first is a pathogen at the level of airways, while the last three are essentially linked to pathologies at the level genital.

Mycoplasma pneumoniae: pulmonary mycoplasma

This bacterium is extremely important within lung diseases, as it is the second cause of community-acquired pneumonia (CAP, community acquired pneumonia) after Streptococcus pneumoniae. It can be contracted through theinhalation of the droplets exhale during the shots cough by a carrier or subject affected by the disease, as the susceptibility of the bacterium to drying is very high (lacking the cell wall).

L'infection by this bacterium it particularly affects young subjects (under the age of 30, and even in pre-adolescent age) and can configure pathological pictures such as tracheobronchitis, bronchiolitis and the picture of "primary atypical pneumonia”, Of which it is the main etiological agent. In this regard, it is good to understand that Streptococcus pneumoniae (o pneumococcus) instead configures a framework called "typical pneumonia" or "lobar frank pneumoniaOn radiological examination, with often different clinical presentation of symptoms.

Mycoplasma pneumoniae it is a pathogen that can be defined pericellular parasite, as does not penetrate within the cells but it stays there tightly attached, blocking its protective ciliary function (at the level of the ciliated epithelium of the airways) and causing cytolysis (cell death) through the production of hydrogen peroxide. Also thanks to the adhesion to the eukaryotic cells of the human body, mycoplasmas are able to multiply, thus leading to the destruction of the oral and respiratory mucosa and the triggering of a mechanism of inflammatory response by the body itself.

Mycoplasma pneumoniae symptoms

How to recognize a mycoplasma infection? What are the symptoms from infection from Mycoplasma in children and in adults? The aggression just described by the bacterium, and the inflammatory response of the organism, lead to what is the picture of atypical pneumonia: this type of infection usually evolves (after a short incubation period) gradually in the 5 - 7 days, sometimes even 2 - 3 weeks, with the presence of symptoms Which sore throat, dry cough, rhinitis (runny nose), weakness, headache is temperature (not always present and usually does not exceed 38 ° C).

Because people with this condition are usually young, and the symptoms don't lead to a serious one malaise (at least initially), these symptoms are often underestimated and, continuing normal activity, the young person favors the worsening of the clinical picture up to more serious manifestations; up to 18-20% of cases of mycoplasma in children can get to require one hospitalization due to the evolution of the disease.

Additionally, there is a significant percentage of cases (up to 25%) in which one develops autoimmune response (the immune system attacks the healthy cells of the body) due to the molecular mimicry that the microorganism possesses: some of its structures, in some cases, may closely resemble structures normally present in human cells; this leads to the development of antibodies for the mycoplasma pneumoniae but they also end up affecting healthy cells.

In these cases, the symptoms can also involve other organs in addition to the lungs (as well as for a possible dissemination of the bacterium itself): central nervous system disorders such as confusion, diplopia, encephalitis, psychosis, coma; dermatological disorders such as erythematous rash vesicular or maculo-papular; septic arthritis; cardiac involvement; haemolytic anemia (rare, but serious); renal involvement with acute glomerulonephritis (rare).

All these complications are to be kept in mind, especially by the doctor, as sometimes the respiratory symptoms they are not very pronounced but there are instead important symptoms in other systems.

Mycoplasma Infection Diagnosis

How to diagnose mycoplasma? In the case of mycoplasma infection, a quick diagnosis is essential to start a correct therapy. In the presence of respiratory symptoms, chest x-ray is often used (Chest X-ray) which can allow to distinguish pneumonia from mycoplasma pneumoniae from a typical S. pneumoniae pneumonia (even more so if a Chest CT scan), thus better targeting the therapy.

The radiograph will show the absence of frank pulmonary thickening, often highlighting an increase in the interstitial and reticular texture of the lungs.

The actual diagnosis is made by analyzing the serology of Mycoplasma, through the finding of antibodies for the Positive Mycoplasma pneumoniae. Another investigation technique is the analysis of sputum or sputum, which may result in positive Mycoplasma pneumoniae; however, the use of this last investigation is not practiced as it is slow and not very reliable (the sample can be contaminated by many other bacteria, including mycoplasma, normally present in the oral cavity).


Mycoplasma pneumoniae can cause atypical pneumonia, characterized by dry and irritating cough and the absence of evident pulmonary parenchymal thickening.

Mycoplasma therapy

When pneumonia is suspected, if it is acquired in the community and not in the hospital, therapy is usually one empirical antibiotic treatment (not targeted) with penicillin antibiotics such as amoxicillin. This is because, in the vast majority of cases, this pathology is sustained by Streptococcus pneumoniae; however, due to the unique Mycoplasma membrane, these antibiotics cannot be effective. Therefore, if the pneumonia pattern persists, a new empirical therapy with different classes of antibiotics should be attempted (tetracyclines, macrolides such as azithromycin or clarithromycin or fluoroquinolones such as ciprofloxacin and levofloxacin), which are able to eradicate M. pneumoniae.

Furthermore, pneumonia therapy is also based on the presence of particular risk factors, such as COPD, diabetes, history of alcoholism or recent antibiotic treatment. In these cases, it is indicated to set up a therapy based on fluoroquinolones such as ciprofloxacin or levofloxacin.

Ureaplasma urealyticum, Mycoplasma hominis and genitalium: urogenital mycoplasmas

These three bacterial species are usually responsible for colonization (often harmless, in which case we speak of "commensal bacteria") and sometimes infectious diseases of both the male and female genital tract. The main clinical picture associated with genital mycoplasma infections is urethritis, an acute inflammation of the sexually transmitted urethral mucosa. They are also possible too cystitis or other types of urinary infection.

How is mycoplasma urealyticum taken?

So how do you take the mycoplasma hominis (also present at the genital level), contagion aside Ureaplasma is related to contact with an infected person through the genital tract: for this we speak of diseases a sexual transmission.

A chain of carriers and / or infected people is then formed, and the bacterium can survive; always according to this logic, it is easy to understand how mycoplasma hominis is transmitted.

Mycoplasma urethritis: symptoms, diagnosis and therapy

In the treatment of urethritis, traditionally we speak of gonococcia urethritis is non-gonococcal urethritis, as the main causative agent for urethritis is, historically, Neisseria gonorrheae (or gonococcus). However, thanks to the prevention and use of antibiotics, the cases of gonorrhea (gonococcal urethritis) have been reduced and other causes of urethritis have acquired more importance, such as agents etiological non-gonococcal (ureaplasma urealyticum, mycoplasma genitalis, chlamydia trachomatis, herpes simplex, trichomonas vaginalis).

As for the symptoms, it is essentially linked to burning, to the itch and in the presence of a erythema level urethra; they may also be present purulent secretions or blood. If left untreated, the infection can spread and cause humans prostatitis and / or epididymitis, with major complications such asinfertility; in women it can cause vaginosis is pelvic inflammatory disease, with significant burning and pain that can also become complicated in this case leading to infertility.

The diagnosis of non-gonococcal urethritis involves first of all the clinical suspicion (derived from the symptoms and signs of urethral inflammation), and above all the implementation of a urethral swab with relative bacterial culture; when it is desired to characterize the pathogen, immunoenzymatic or gene amplification investigations can also be carried out.

Ureaplasma or urealitic mycoplasma

Mycoplasma urealyticum, a germ that frequently gives urinary infections.

Mycoplasma in pregnancy

The presence of Mycoplasma infection in pregnancy should not be underestimated: the presence of a positive buffer in a pregnant woman it may indicate the presence of a simple colonization or, in the most serious cases, of a real infection by Mycoplasma and Ureaplasma, in the latter case with serious complications for the fetus.

In particular, the presence of positive mycoplasma in pregnancy, i.e. the presence of important colonies (symptomatic and otherwise) of Mycoplasma urealyticum and other mycoplasmas is associated with an increased risk of abortion you hate premature birth; in addition, it is possible that the infection passes to the newborn during delivery, leading to the development of neonatal pneumonia, meningitis and sepsis.

It is very common to find, inside the vaginal flora, the presence of these bacteria; however, the presence of vaginal mycoplasma is not necessarily alarming as, in conditions of physiological hygiene, the lactobacilli normally present compete with these bacteria preventing excessive development. It seems that the possibility of finding vaginal mycoplasma is directly proportional to number of partner had during the whole life of the woman, as they increase the chances of transmission of mycoplasma; protective factors, to prevent contagiousness, the use of is undoubtedly indicated condoms, a limited number of partner, a correct one Personal care and seeing a doctor when symptoms are felt or if bacteria have been found in the partner.


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