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Mycoplasma Genitalium

Mycoplasma Genitalium refers to a sexually transmitted disease (STD) that is caused by a pathogenic bacteria of the same name. It affects both men and women. These organisms live in the urinary and genital tracts of humans and attach themselves to the surface of the genital tract and attack the tissue of the host. Though the presence of Mycoplasma genitalium was known 30 years ago, it has been recently identified as STD and extensive research is being carried out to establish the connection between risky sexual behavior and development of Mycoplasma Genitalium. It is also proven that the risk of infection increases for those with multiple sexual partners.


Often, Mycoplasma genitalium in men is associated with urethritis and bacterial vaginosis in women. Cervicitis, pelvic inflammatory disease and Endometriosis are some of the other conditions associated with Mycoplasma genitalium in women. This condition is also known to cause infertility in women. Urethritis in men could also be caused by conditions like gonorrhoea or Chlamydia and hence these conditions are primarily ruled out before probing for Mycoplasma genitalium. Mycoplasma Genitalium Urine Test is recommended for people who have tested negative for other bacterial infections such as Chlamydia and Gonorrhea but continue to experience symptoms.


Mycoplasma genitalium does not cause symptoms at the initial stage. It usually takes 1 to 3 weeks for the symptoms to show up. And also, it often occurs in conjunction with other sexually transmitted infections. As the symptoms start to surface, it is advisable to get tested for Mycoplasma genitalium separately along with other STD related diagnostic tests.

Symptoms in men may include


  • Burning sensation while urinating
  • Discharge from the penis
  • Inflammation of urethra

Symptoms in women

Most often, Mycoplasma genitalium in women causes infection in cervix. Bleeding after sex is the most common symptom associated with Mycoplasma genitalium in women. Some of the other symptoms include:


  • Abnormal discharge
  • Cervicitis or inflamed cervix
  • Pain during intercourse
  • Bleeding in between periods

Mycoplasma organisms are difficult to culture and identify. Diagnosis of infection is performed using nucleic acid amplification tests (NAATs). In case of men, the first passed urine and in case of women endocervical/ vaginal swab are collected to conduct test. Polymerase Chain Reaction (PCR) is a popularly followed NAAT test to detect Mycoplasma genitalium.


Treatment

Mycoplasma genitalium is treated with antibiotics. The antibiotic azithromycin has been generally successful against Mycoplasma genitalium infection. But there are instances where mycoplasma genitalium has developed resistance to azithromycin. Antibiotics like moxifloxacin and doxycycline are also widely recommended to treat the condition.


Precautions


  • Mycoplasma genitalium is sexually transmitted; hence abstinence from sex should be strictly followed during the course of treatment.
  • Both the partners involved should be treated at the same time to avoid recurrence.
  • Test of cure is normally advised after six weeks to assess if the infection has cleared.
  • Usage of condoms is the best practice to prevent not only Mycoplasma genitalium but also other STDs.

Pelvic Inflammatory Disease

Nearly 1 million women in the US alone suffer from pelvic inflammatory disease or PID each year; PID is an infection in the reproductive organs of a woman. It is essential to treat the symptoms of Pelvic Inflammatory Disease immediately when noticed. Failure to do so may lead to complications such as infertility and even can be life threatening. Sexually transmitted diseases (STD) such as chlamydia or gonorrhea are often the cause for pelvic inflammatory disease. Women who have multiple sexual partners or partners with symptoms of chlamydia or gonorrhea infections are at a higher risk for PID. Some forms of contraception such as IUDs may put a woman at increased risk of PID. Surgical procedures such as D and C (Dilation and Curettage), insertion of IUD or treatment of an abnormal Pap smear can lead to pelvic inflammatory. Usually the cervix prevents the spread of bacteria into the internal organs. But when the cervix gets infected with an STD (Sexually Transmitted Disease), disease-causing bacteria travel up the internal organs and damage the uterus, fallopian tubes, ovaries and abdomen. Bacteria present in the vagina and cervix can also have a precipitating effect on the Pelvic Inflammation. Usually multiple organisms are responsible for a bout of PID. Spreading of the infection can lead to further inflammation and scarring.


Women suffering from PID experience high fever and chills. Dull pain in the lower abdomen and lower back are typical symptoms of pelvic inflammatory disease. A woman suffering from pelvic inflammatory disease may also experience fever and irregular menstrual bleeding. Other symptoms of Pelvic Inflammatory Disease are pain during intercourse and urination. Some women do not experience any symptoms at all. Laboratory tests for chlamydia, gonorrhea and urinary tract infection are conducted on a patient who might be suffering from PID. A pelvic ultrasound helps in looking for any abnormalities in the pelvic area or fallopian tubes. Pelvic Inflammatory Disease can also be diagnosed with falloposcopy - a visual study of the inside of the fallopian tubes.


Treatment for pelvic inflammatory disease is based on pelvic examination and examination of the woman's sexual and menstrual history. Antibiotic therapy of Floxin is used as oral medication for PID. This is the first FDA approved oral therapy for PID. Other drugs used in combination for treatment of Pelvic Inflammatory Disease are Cefoxitin, Oflaxocin, Clindamycin. If left untreated, pelvic inflammatory disease can lead to severe and permanent damage of the reproductive organs.


Syphilis

Syphilis is a sexually transmitted bacterial infection or STD. It is caused by Treponema pallidum, a spiral-shaped bacterium. It can affect both men and women who are sexually active. Syphilis can be transmitted from an infected person to another during oral, anal and vaginal sex and oral-genital contact. It can also be passed on by direct skin contact with someone who has syphilis sores or a syphilis rash and by sharing sex toys. Syphilis can also be transmitted by blood transfusion. Those who have tested positive for syphilis are vulnerable to other STD like Gonorrhea and HIV.

Syphilis develops in stages. Not everyone will go through all the stages. Between the stages are periods that are symptom-free or latent periods. When the infection is active, symptoms are noticeable. When it's not active, the symptoms are unnoticeable but syphilis persists.

Primary syphilis: Syphilis is highly contagious during the first stage. The incubation period is around 21 days before the first signs and symptoms appear. A painless red sore called a chancre appears on the part of the body like vagina, rectum, penis or mouth, places where the spirochetes moved from the infected person to another. The painless sore isn't noticed or recognized most of the time and the infected individual may not fall ill. The chancre may heal after 4 to 6 weeks but it does not indicate that syphilis has actually gone away. It continues to spread throughout the body.


Secondary syphilis: The bacterial has spread into the bloodstream. Without treatment, blood-borne spread of Treponema pallidum over the next several weeks to months results in secondary syphilis. It usually occurs 2 to 8 weeks after the appearance of chancre sore and several weeks after chancre have healed. Symptoms include fever, multiform skin eruptions, iritis, alopecia, mucous patches and severe pain in the head and joints. The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection will progress to the latent stage of disease.

Latent (hidden) syphilis: The signs of the disease may go away, but the disease is present in the body. Syphilis can remain latent for many years.

Tertiary syphilis: Also termed as late-stage syphilis, tertiary syphilis may occur many years after the original infection. The infection has already spread all over the body and can affect the brain, heart, spinal cord and bones. Symptoms vary depending on which organ is infected and affected.

Congenital syphilis: A pregnant syphilis infected woman may pass on the infection through the placenta to the child during fetal development or delivery which is referred to as congenital syphilis. If the infected pregnant woman is not treated before 18th week of pregnancy, the child is most likely to be affected with congenital syphilis. Some babies with congenital syphilis have no symptoms at birth but develop them in a few weeks if not treated immediately. As a precautionary measure, syphilis screening tests (VDRL, RPR, FTA-ABS) has been made a routine part of prenatal care during pregnancy.

Jarisch Herxheimer Reaction: A temporary reaction to penicillin treatment for syphilis that manifests in the form of fever, chills and skin rash or chancre.

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Bibliography / Reference

Collection of Pages - Last revised Date: November 11, 2019