Patient's question:
What does a positive Mycoplasma test mean? How does this result occur? What are the serious consequences? First follow-up question: How can it be treated? Can medication treat it? Is Mycoplasma infection a sexually transmitted disease? Is it easy to treat? I'm a little scared. Second follow-up question: How can it be treated? Can medication treat it? Is Mycoplasma infection a sexually transmitted disease? Is it easy to treat? I'm a little scared.Doctor's answer:
What are the routes of transmission for chlamydia and mycoplasma infections?The infection of adult chlamydia and mycoplasma is primarily sexually transmitted. In children, the infection is mainly caused by indirect contact, especially in young girls, as they can be infected through indirect contact with their mothers or caregivers who have the disease. For example, if a mother is infected with mycoplasma, it can be transmitted to the newborn during delivery through the reproductive tract. Under intact fetal membranes, mycoplasma can be isolated from amniotic fluid, the placenta, and fetal blood, indicating that the fetus can also be infected in utero.
Chlamydia and mycoplasma infections of the urogenital system are one of the factors contributing to male infertility. Chlamydia can interfere with the development and maturation of sperm. Some reports using electron microscopy have detected chlamydia in the semen, testes, and epididymides of infertile men, showing significant abnormalities in sperm morphology. The lumen of the curved seminiferous tubules is blocked by immature germ cells, and the basal membrane is damaged with extensive fibrosis. The epididymis exhibits ciliary loss, and the epididymal lumen is filled with membranous remnants. Therefore, it is believed that chlamydia infection causes damage to the testes and epididymides. Chlamydia not only adheres to the surface of sperm but can also enter the sperm, leading to the destruction of the sperm membrane and acrosome. In cases of immunological infertility, the positive rate of chlamydia antibodies is also relatively high. The mechanism may involve increased white blood cell activity and phagocytosis of sperm, as well as heightened contact between sperm antibodies and white blood cells, leading to the production of antisperm antibodies.
Regarding how mycoplasma affects sperm motility and fertility, it is not yet fully understood. However, scholars suggest the following pathways:
(1) Impact on normal physiological functions of sperm: Mycoplasma infection-induced epididymitis and chronic prostatitis can impair normal sperm function. A large number of mycoplasma adhering to sperm make them swollen, increasing resistance to forward movement and reducing their motility and ability to penetrate the egg. Mycoplasma adhesion also affects the egg's recognition of sperm.
(2) Toxic effects of ammonia: Ureaplasma, a characteristic of mycoplasma, requires and utilizes urea during growth. The decomposition products of urea, such as amines, and the resulting alkaline environment are pathogenic.
(3) Metabolic effects of mycoplasma infection: Mycoplasma lacks a cell wall. When adhering to host cell surfaces, toxic substances in the mycoplasma cytoplasm are directly absorbed by host cells, causing damage and destruction.
(4) Neuraminidase-like substances produced by ureaplasma interfere with fertilization.
In summary, urogenital infections caused by chlamydia and mycoplasma are closely associated with male infertility, and the incidence is gradually increasing, attracting significant attention from scholars and male patients. Through nearly eight years of clinical observation, our hospital has found that oral administration of Non combined with drugs like Gelidezhi and Xie Tong Bi often yields good results.
### Clinical Manifestations of Non-Gonococcal Urethritis – Mycoplasma Infection
The incubation period is 1–3 weeks. Typical acute symptoms are similar to other non-gonococcal genitourinary infections, including urethral pain, varying degrees of urgency and frequency, dysuria, especially when urine is more concentrated. The urethral orifice may show mild redness and swelling, with thin, scanty, serous or purulent discharge. Significant pressure on the urethra is often required to expel discharge. In the morning, the urethral orifice may have a small amount of mucopurulent discharge or a crust-like seal, or the underwear may appear soiled. About one-third of patients show no symptoms and are only detected during routine examinations. 50% of patients are initially misdiagnosed or overlooked, and approximately 10–20% have concurrent gonococcal infection.
In the subacute phase, prostatitis often coexists. Patients may experience perineal discomfort, lower back pain, or discomfort in the inner thighs, or a radiating pain from the perineum to the inner thighs during Kegel exercises. Digital examination may reveal an indistinct longitudinal groove in the prostate or an uneven, walnut-like surface. In some cases, B-mode ultrasound can confirm varying degrees of prostate enlargement. Epididymitis is uncommon.
Female patients often exhibit genital inflammation centered around the cervix. Most show no symptoms, but some severe cases may experience vaginal discharge. When the infection spreads to the urethra, frequent urination and urgency are the primary symptoms. Localized cervical infection manifests as increased leukorrhea, turbidity, edema, congestion, or erosion of the cervix. Urethral involvement shows redness, congestion, and occasional discharge upon urethral compression, though pain is rare.
The most common complication of mycoplasma infection is salpingitis. Endometritis and pelvic inflammatory disease occur in fewer cases.
### Mycoplasma Infection
Mycoplasma is a type of hospital microorganism, very small in size, with properties similar to bacteria. Treatment primarily involves antibiotics, and it is generally classified as a bacterial infection. In medicine, infections caused by chlamydia and mycoplasma are referred to as non-gonococcal urethritis or non-gonococcal cervicitis. However, as the complexity of these infections increases, medical professionals are gradually distinguishing between them. Infections caused by chlamydia are termed chlamydia-induced genital tract infections, while those caused by mycoplasma are called mycoplasma-induced genital tract infections. Broadly, they can be collectively referred to as "non-gonorrhea," a term many netizens are familiar with, especially those infected with chlamydia and mycoplasma. Chlamydia, typically the trachoma type, exists in multiple strains, with the urethra primarily affected. Mycoplasma has four types: Mycoplasma pneumoniae, mainly infecting the lungs and bronchi (outside the scope of this discussion); Mycoplasma genitalium, Mycoplasma hominis, and Ureaplasma urealyticum, which are particularly prone to infecting the urogenital system and are the focus of this discussion. The treatment of chlamydia and mycoplasma infections is highly complex, especially when the infection persists and spreads to other tissues and organs, making treatment more challenging. Many patients remain untreated for extended periods due to improper medication. Ideal treatment drugs include Weilin Jintong Su, among others.
### Treatment of Ureaplasma Infection
Ureaplasma infections can be treated with medications such as Roxithromycin, Minocycline, Doxycycline, and Levofloxacin. Good hygiene is essential, as ureaplasma can be transmitted between individuals.