Mycoplasma h. Mycoplasma and mycoplasmosis, symptoms, treatment in men and women

• M. pneumonia - causes pulmonary (respiratory) mycoplasmosis;
• M. incognitus - causes a generalized form of mycoplasmosis;
• M. hominis - causes the urogenital form of mycoplasmosis;
• M. genitalium - causes the urogenital form of mycoplasmosis;
• U. urealyticum - causes the urogenital form of mycoplasmosis.

The causative agents of the disease are sensitive to antibacterial drugs from the group of macrolides, fluoroquinolones and tetracyclines. Also outside human body perish from boiling, disinfecting solutions and from exposure to ultraviolet radiation.

Causes and mechanism of development of mycoplasmosis

Mycoplasmosis: symptoms and treatment

Human mycoplasmosis is divided into respiratory (pulmonary) and urogenital. Each has its own characteristics of the course and treatment. Respiratory is treated by a general practitioner or pulmonologist. Urogenital - urologist or gynecologist.
A certain type of mycoplasmosis has its own incubation period. Let's consider them separately.

Respiratory mycoplasmosis

It is transmitted by airborne droplets or from mother to fetus through the placenta. It is divided into mycoplasmal bronchitis and mycoplasmal pneumonia (pneumonia). The former are similar in course to the flu or other viral infection, only with a longer course.
The incubation period is 1-2 weeks. In rare cases, it reaches 3-4 weeks. It starts with fever, nasal congestion and severe cough. After the lungs are attached to the process, an even greater increase in temperature occurs, the cough becomes with a small amount of sputum, shortness of breath occurs. The duration of this variant of mycoplasmosis is about 2-3 months.
In severe cases of the disease, it is necessary to stay in the hospital. For therapy, antibiotics, antitussives (in the first few days), expectorants, antipyretics and vitamins are used. Antifungal drugs are also used in the treatment.

Urogenital mycoplasmosis

Clinical manifestations after the ingestion of mycoplasma begin to develop after a period of time from 3 days to 3 weeks. In 80% of cases, infection occurs sexually. However, contact is not excluded. There are asymptomatic, acute and chronic. It manifests itself in minor discharge from the vagina or urethra. Just concerned about the itching of the genitals, cramps when urinating, pain in the lower abdomen. In women, menstrual irregularities are possible, in men, pain in the scrotum and anus.
Chronic mycoplasmosis sooner or later leads to various complications. For women, it is most often infertility, persistent miscarriages or premature births. In this case, the child becomes ill with a pulmonary form of the disease. For men, infertility is most common. Both sexes may experience pyelonephritis (inflammation of the kidneys), cystitis (inflammation Bladder), arthritis (inflammation of the joints).
The consequences of mycoplasmosis of the respiratory form are bronchiectasis (irreversible expansion of the bronchi) and pneumosclerosis (replacement of normal lung tissue with connective tissue). These are the most common complications. But if not proper treatment more serious consequences are possible. This is encephalitis (inflammation of the brain) or a generalized lesion (when almost all organs and systems of human organs are included in the disease process).

Prevention of mycoplasmosis

There is no vaccine for mycoplasmosis. Therefore, for the prevention of the pulmonary form, it is necessary to follow the same methods as for other colds. And in order to avoid the genital form of the disease, it is necessary to exclude casual sexual intercourse, especially unprotected ones, carefully examine pregnant women, properly process gynecological instruments, and adequately treat patients with mycoplasmosis.

Diagnosis of mycoplasmosis

Diagnosis of mycoplasmosis is a rather difficult task. This is explained by the fact that with this disease there are no signs characteristic only of him. They can also be found in a number of other pathologies. But the presence of chronic inflammation genitourinary system can push the doctor to think about mycoplasmosis, after which the doctor's thoughts are confirmed or refuted in the laboratory.
Laboratory diagnostic methods include:

Mycoplasmosis does not have symptoms that would be characteristic only of this disease. All complaints that a patient can make are also found in other pathologies of the respiratory or genitourinary system. However, the combination of several signs helps to prompt the doctor to the idea of ​​the need to examine the patient for mycoplasmosis.
Mycoplasma can infect the human respiratory system (respiratory or pulmonary mycoplasmosis) and urogenital (urogenital mycoplasmosis). Depending on the localization of the disease, complaints will differ.
Respiratory mycoplasmosis includes the following symptoms: in the first days from the onset of the disease, a sore throat appears, nasal congestion and a strong, paroxysmal dry cough occur, and body temperature rises to 38 ° C. After 1-2 weeks, the temperature rises to 39°C, the cough becomes paroxysmal, with a small amount of sputum, sometimes streaked with blood. There is strong shortness of breath, blue lips. This suggests that the lungs were involved in the process. This condition can last up to three months.
Signs of mycoplasmosis of the genitourinary system can be so mild that the patient does not pay attention to them for a long time. First of all, patients notice slight discharge from the vagina or urethra. Itching in the area of ​​the glans penis and urethra in men and in the area of ​​the entrance to the vagina in women will also be characteristic signs. They may be disturbed by cramps and discomfort during urination. If the infection spreads higher throughout the body, then women may experience intermenstrual bleeding, irregular menstruation, pain in the lower abdomen of a pulling nature. In men, the symptoms of mycoplasmosis are divided by the affected organs. If the testicles and their appendages are involved in the process, then the above complaints are accompanied by heaviness in the scrotum, its slight swelling. If the prostate gland is affected, then there is frequent nighttime urination, pressing pains in the lower abdomen or anus. Urine becomes cloudy, sometimes streaked with pus.

Complications of mycoplasmosis

Considering that the causes of mycoplasmosis are a small microorganism that does not always cause any complaints in the patient, complications of the disease are often possible. These include bronchiectasis (pathological irreversible expansion of the bronchi), encephalitis (inflammation of the brain), pyelonephritis (inflammation of the kidneys). As well as arthritis (inflammation of the joints), infertility, premature birth, frequent miscarriages. That is why, in order to prevent such serious consequences, it is necessary, at the slightest suspicion of mycoplasmosis, to consult a pulmonologist, gynecologist or urologist (depending on the affected system).

Treatment of mycoplasmosis

Treatment of respiratory mycoplasmosis

For the treatment of respiratory mycoplasmosis, antibacterial drugs are the main ones. Most effective against mycoplasma:

• tetracyclines - tetracycline (750-1000 mg per day, divided into 3 doses), doxycycline (200 mg per day, divided into 2 doses);
• fluoroquinolones - ofloxacin (600 mg per day, divided into 2 doses), ciprofloxacin (1000 mg per day, divided into 2 doses);
• macrolides - sumamed (500 mg 1 time / day or 1 g once), erythromycin (2000 mg per day, divided into 4 doses), clarithromycin (1500 mg per day, divided into 3 doses), azithromycin (1 g once or 500 mg 1 time / day).

The duration of treatment can take from 7 days (in mild cases) to 21 days (in severe cases). Antibiotics for mycoplasmosis are selected strictly individually.
Symptomatic drugs are also used to treat pulmonary mycoplasmosis. These are antitussives (codterpin 1 tablet no more than 4 doses per day, stoptusin 1 tablet in 3 doses) - they are used in the first few days of illness with a painful paroxysmal cough. Expectorants (Ambroxol 1 tablet in 3 divided doses, Lazolvan 1 tablet in 3 divided doses, ACC 1 sachet in 4 divided doses) - with a painful cough with sputum difficult to pass. Antipyretic (paracetamol 1 tablet in 4 doses, nimid 1 tablet in 2-4 doses, ibuprofen 1 tablet in 3 doses) - with an increase in body temperature from 38 ° C. For sore throats - sprays with antiseptics (Jox, Stoptusin, Givalex) or tablets (Decatilene, Strepsils) - every 3-4 hours. With nasal congestion - spray or drops (nazol, noxprey, aquamaris, naphthyzinum).
In severe cases, treatment should take place strictly in a hospital under the supervision of a doctor.

Treatment of urogenital mycoplasmosis

The main drug in the treatment of urogenital mycoplasmosis, as well as respiratory, is an antibiotic. Groups and dosages are the same. However, the duration of treatment is from 3 to 7 days. This is due to the milder course of the disease. In addition to this drug, antifungal drugs are used (fluconazole 100 mg, 1 tablet daily for 10 days or 500 mg once after a course of antibacterial drugs). Probiotics to restore microflora (Linex 1 capsule in 3-5 doses, Bifiform 1 capsule in 3-4 doses, Lacidophil 1 capsule in 3-4 doses). To strengthen the immune system, vitamins are used (Vitrum, Kvadevit, Undevit - 1 tablet in 4 doses) and immunostimulants (Laferon, 1 tablet in 3 doses, interferon is instilled into the nose every 2 hours).
Treatment of mycoplasmosis in women to all of the above adds vaginal suppositories with antibiotics (metronidazole 1 suppository at night for 10 days, gravagin 1 suppository at night for 7-10 days).
After the end of therapy, a woman needs to undergo a control study. To do this, 10 days after the last antibiotic tablet, a female doctor (gynecologist) takes a smear and does a sowing. This procedure must be carried out three times, during each subsequent menstrual cycle. Only if during these three months all the results are negative, the woman can be considered healthy.
Treatment of mycoplasmosis in men adds to general principles ointments or creams containing antibacterial substances (metrogil, oflokain - rub into the head of the penis 2-3 times a day for 1-2 weeks). At the end of the treatment, the treatment is monitored. Any method of laboratory research that is available in a medical institution, a male doctor (andrologist or urologist) checks for the presence of mycoplasma in the body.

Treatment of mycoplasmosis in children

Treatment of mycoplasmosis in children is one of the most difficult tasks. The reason for this is the severity of the course of the disease. It is recommended that all children be hospitalized after such a diagnosis is made.
The basis for eliminating the cause of the disease are antibiotics. If the child is under 12 years old, then he is shown macrolides in the form of a suspension or capsule, and if the condition is extremely severe, then intramuscularly or intravenously fluoroquinolones.
The approximate scheme for the treatment of mycoplasmosis in children includes drugs such as:

• Antibacterial drug - azithromycin (Sumamed) - 10 mg / kg of body weight;
• Expectorants - Dr. Thais syrup, Dr. MOM syrup - up to 6 years, ½ teaspoon, from 6 to 12 years, 1 teaspoon, from 12 years, 1 tablespoon 4-6 times a day.
• Antipyretics - nurofen - up to 3 years, 2.5 ml 2 times a day, from 3 to 6, 5 ml 2-3 times a day, from 6 to 12, 7.5 ml 4 times a day, from 12 years old, 10 mo 4 times a day day.
• Probiotic - bifiform 1 capsule 2-3 times a day.
• Immunostimulator - interferon leukocyte instilled into the nose every 2 hours.
• Plentiful drink.

A pediatrician (pediatrician) will prescribe a full treatment depending on the symptoms, the condition of the child and his age. In no case should you self-medicate.

Treatment of mycoplasmosis with folk remedies

Treatment of mycoplasmosis folk remedies can be allowed only with the urogenital form, not complicated course. Here are a few recipes that are good to use for asymptomatic or asymptomatic variants:

• Steep 3 tablespoons of goldenrod herb in 3 cups boiling water for 45 minutes. Take ½ cup 4-6 times a day for 21 days.
• 15 g of the collection (upland uterus, winter love grass and wintergreen) pour 3-4 glasses hot water and insist 45-50 minutes. Take ½ cup 5 times a day for 21-28 days.
• Pour 2 tablespoons of oak bark and 1 tablespoon of boron uterus with 1 ½ cups of boiling water, leave for 30-45 minutes. Use as a vaginal douche 2 times a day.

Prevention of mycoplasmosis

There is no specific prophylaxis (vaccine) against mycoplasmosis.
From pulmonary mycoplasmosis, it is necessary to adhere to the same rules as for other respiratory tract infections (hardening, maintaining immunity, taking vitamins).
Prevention of mycoplasmosis of the urogenital form includes compliance with the rules of personal hygiene, adequate sterilization of gynecological instruments, water purification in public pools. It is also necessary to adequately identify and treat patients with mycoplasmosis. We must not forget about safe sexual intercourse. In addition, women need to undergo a preventive examination by a gynecologist every six months.

Mycoplasmosis in women

The incubation period after contact with mycoplasmas ranges from 4 to 55 days (average 14 days). But due to the fact that most often mycoplasmosis in women occurs in asymptomatic or asymptomatic forms, it is practically impossible to determine the moment of infection. The ratio of the incidence of mycoplasmosis in men and women is 1:2.
Due to the fact that the sexual route of transmission of the infection is predominant, women are able to become infected not only directly through sexual contact, but also through everyday contact - through towels, sheets or gynecological instruments.
Increase the frequency of detection of mycoplasmas in patients and a low level of social status, the use of hormonal contraception instead of condoms, a sexual partner with various sexually transmitted diseases.
Mycoplasmosis in women is classified according to the location of the lesion:

• mycoplasmal bartholinitis (damage to specific glands near the entrance to the vagina);
• mycoplasmal vaginitis (damage to the mucous membrane of the vagina);
• mycoplasmal endometritis (damage to the inner lining of the uterus);
• mycoplasmal salpingitis (damage to the fallopian tubes), etc.

Symptoms of mycoplasmosis in women

Diagnosis of mycoplasmosis in women

Several laboratory methods are used to diagnose mycoplasmosis. These include:

The main complications of mycoplasmosis in women include an abscess of the gland of the vestibule of the vagina (purulent inflammation), inflammation of the bladder and kidneys, infertility, habitual miscarriages, chronic endometritis (inflammation of the inner lining of the uterus), placental insufficiency (pathology of the placenta, causing a number of diseases in the fetus), intrauterine fetal disease without placental pathology.

Treatment of mycoplasmosis in women

Mycoplasmosis in men

The incubation period for mycoplasmosis in men ranges from 4 to 55 days (average 14 days). But due to the fact that most often mycoplasmosis occurs in asymptomatic or asymptomatic forms, it is practically impossible to determine the moment of infection. Men get sick less often than women. The ratio of the incidence of mycoplasmosis in men and women is 1:2.
Mycoplasmosis is divided according to the location of the lesion:

• mycoplasmal urethritis (damage to the urethra);
• mycoplasmal prostatitis (damage to the prostate);
• mycoplasmal orchitis (infection of one or both testicles)
• mycoplasmal epididymitis (damage to the epididymis).

Symptoms of mycoplasmosis in men

Mycoplasmosis does not cause characteristic symptoms in men. Most often, everything proceeds almost imperceptibly and there is no thought to consult a doctor. The disease begins with minor discharge from the genitals and unmotivated discomfort. Also, the symptoms of mycoplasmosis in men include itching and pain in the penis. In rare cases, there may be pain in the perineum, scrotum, and even give into the anus.
With mycoplasmal urethritis, symptoms include purulent discharge of various amounts, cloudy urine, discomfort in the glans penis, itching or burning throughout the urethra. If this is an acute course of mycoplasmosis, then the signs are more pronounced and this may prompt a man to go to the hospital. But in the chronic course, there are practically no complaints, the patient does not go to the doctor, which can lead to various complications.
Mycoplasmal prostatitis occurs in men who already suffer from urethritis, and due to predisposing factors, the infection penetrates into the gland itself. These factors include regularly interrupted or prolonged sexual intercourse, the presence of frequent constipation, drinking alcohol, etc. Patients may notice more frequent urination at night, the appearance of purulent threads in the urine, or even clouding of the urine. With a long course chronic prostatitis there is a decrease in potency.
With mycoplasmal epididymitis and orchitis, a man feels slight pulling pains in the scrotum, rarely there may be a slight swelling of the scrotum, which the patient may not notice.

Diagnosis of mycoplasmosis in men

Some laboratory methods are used to diagnose mycoplasmosis. These are such as:

With untimely or incorrect treatment, mycoplasmosis in men can cause a number of complications. These include:

• Mycoplasma pyelonephritis (inflammation of the substance of the kidney);
• Mycoplasma cystitis (inflammation of the bladder);
• Male infertility (caused by impaired sperm movement or formation);
• Mycoplasma arthritis (inflammation of the joints).

Treatment of mycoplasmosis in men

Mycoplasmosis in children

Mycoplasmosis in children is a rather serious disease that is caused by mycoplasmas and has a number of clinical signs. The incubation period ranges from 4 days to 3 weeks (depending on the form of the disease). Just like adults, children can be carriers of mycoplasmas or the disease can be asymptomatic. The appearance of clinical signs in these cases is possible after stress or against the background of reduced immunity. Infection can occur in utero (from a sick mother), by household means (through towels, bedding, underwear), sexually (with sexual perversion, rape) and by airborne droplets (infection occurs quite rarely).

Symptoms of mycoplasmosis in children

Mycoplasmosis in children is divided into clinical forms:

• respiratory - affects the upper respiratory tract;
• pneumonic - affects the lower respiratory tract;
• urogenital - affects the genitourinary system;
• perinatal - affects the fetus from the mother;
• generalized - damage to the whole body, an extremely severe form.

Mycoplasmosis in children, depending on the form, causes the following symptoms:
Respiratory form: From the beginning of infection to the development of the clinic, it takes from 4 to 7 days. The body temperature rises to 38 ° C, however, intoxication (weakness, body aches, headache, drowsiness) no. The upper parts of the respiratory system (larynx, trachea, bronchi) are affected. Rarely, symptoms of obstruction (difficulty inhaling and exhaling air) may occur. It flows quite easily. However, with improper treatment, complications may occur: the attachment of other microorganisms, lymphadenopathy (damage to the lymphatic system), cervical lymphadenitis (inflammation of the cervical lymph nodes).
Pneumatic form: From the beginning of infection to the development of the clinic, it takes from 1 to 3 weeks. The onset can be either acute or gradual. With acute development in a child, the body temperature rises to 39°C within a week, after which it remains at 37.5-38°C for another 4 weeks. Signs of intoxication are slightly pronounced, the upper and middle respiratory tracts are affected (up to medium-sized bronchi), slight shortness of breath appears, the liver and spleen are enlarged, there may be pain in the joints. With a gradual onset, the symptoms of mycoplasmosis in children are more severe. During the week, body temperature fluctuates from 37.5 to 38°C, after which it rises to 39°C and does not go astray for a long time. Signs of intoxication are pronounced, the lower respiratory tract is affected (down to the level of the lungs), severe shortness of breath, lips become blue. There is bilateral inflammation of the lungs. A dry, painful, paroxysmal cough is characteristic, which after 3-4 weeks of illness becomes wet, a large amount of purulent yellow sputum is discharged, possibly even with blood. Complications of this form of childhood mycoplasmosis can be sinusitis (inflammation of the nasal mucosa), otitis (inflammation of the ear), pyelonephritis (inflammation of the kidneys), hepatitis (inflammation of the liver), DIC (pathology of blood clotting), encephalitis (inflammation of the brain), emphysema of the lungs (increased airiness of the lung tissue).
Urogenital form: incubation period from 3 days to 3 weeks. The symptoms are the same as in adults. Does not occur frequently in adolescence. Minor discharge from the urinary organs, mild itching, discomfort, possible cramps during urination, pulling pains in the lower abdomen, in guys heaviness in the scrotum. For diagnosis, the same methods are used as in men and women. Complications can be cystitis (inflammation of the bladder), pyelonephritis (inflammation of the kidneys), endometritis (inflammation of the uterus), salpingo-oophoritis (inflammation of the fallopian tubes and ovaries), epididymitis (inflammation of the epididymis), orchitis (inflammation of the testicles), prostatitis (inflammation of the prostate). Long-term effects include infertility (both male and female), spontaneous miscarriages.
perinatal form: infection occurs in utero from a mother with mycoplasmosis. The child is born prematurely, does not correspond to its developmental period, has severe respiratory and brain disorders, pathological jaundice. The immune system is also poorly developed. This is evidenced by the development of thrush, a long-term non-healing umbilical wound. It is also possible intrauterine death of the fetus.
Generalized form: this mycoplasmosis in a child affects almost the entire body. Involved in the process the cardiovascular system, nervous, musculoskeletal, skin. Survival in this case is not very high.

Treatment of mycoplasmosis in children

Mycoplasmosis during pregnancy

Treatment of mycoplasmosis during pregnancy

Treatment of mycoplasmosis during pregnancy should be based on the basic principles:

• it is necessary to prevent the transmission of microorganisms to the fetus and unborn child,
• therapy is prescribed only if mycoplasmas are found in an amount of at least 100 CFU per 1 ml (colony-forming units),
• treatment must be complete and not harm either the fetus or the expectant mother.

Due to the fact that most antibacterial drugs are able to pass through the placenta and cause fetal malformations, the doctor must carefully consider the choice of medication. Given the deterioration of the immune system when carrying a child, a woman should take a large amount of vitamins. There are special vitamins for pregnant women, in which the content of all substances is increased by 2-3 times. This, for example, pregnavit, vitrum prenatal, elevit. But the treatment of mycoplasmosis during pregnancy still will not do without antibiotics. The safest are drugs from the group of macrolides. They have the least effect on the fetus, do not cause malformations and have the shortest course of administration. The most optimal of all drugs in this group is to prescribe josamycin. It must be taken only from the second trimester of pregnancy (not earlier than 12 weeks). This is due to the fact that up to 12 weeks the fetus is forming organs, and after that they only increase in size. Therapy regimen: take 500 mg 3 times a day (7-10 days). Or another option is possible: drink azithromycin 1 g once, and then 250 mg for 3 days.
After the course of therapy is completed, and the doctor does not see signs of inflammation in the mirrors, it is necessary to conduct a control study. It is made 1 month after taking the last antibiotic tablet.
We must not forget that, along with future mother it is necessary to treat her sexual partner as well. Otherwise, all the symptoms of mycoplasmosis may return again.

Urogenital mycoplasmosis

Urogenital mycoplasmosis is caused by two types of bacteria: Ureaplasma urealyticum and Mycoplasma hominis. Of all the inflammatory lesions of the genitourinary system, mycoplasmosis has recently taken 40-45%. Due to the fact that patients rarely go to the doctor and are increasingly self-medicating, or do not pay attention to the signs of the disease at all, advanced forms of the disease are increasingly common, with many complications.
The incubation period for genital mycoplasmosis ranges from 3 days to 3 weeks. But due to the fact that the disease is often asymptomatic or oligosymptomatic, it is not possible to determine the time of infection. The ratio of the incidence of mycoplasmosis in men and women is 1:2.
The route of transmission of urogenital mycoplasmosis is mainly sexual. However, it is possible to become infected in the household way - through bed linen, towels. Also, women can get mycoplasmosis at a gynecologist's appointment with poor processing of instruments (through gynecological mirrors, gloves).

Symptoms of urogenital mycoplasmosis

Urogenital infection caused by mycoplasmas is divided into acute, chronic and asymptomatic. Very often, mycoplasmosis is detected during a routine examination by a gynecologist by chance.
Symptoms of mycoplasmosis in men are minor discharge from the urethra, slight itching inside the canal or on the glans penis, pain during urination, and discomfort in the genital area. Also, when the testicles and their appendages are affected, mild soreness and slight swelling of the scrotum occur. When a genital mycoplasma infection is attached to the prostate, there may be an increase in nocturnal urination, slight pressing pain in the anus or lower abdomen.
Symptoms in women are divided into mycoplasmosis of the external and internal genital organs. Signs of damage to external organs include slight itching in the area of ​​​​the entrance to the vagina, minor discharge from the urethra or vagina. And if mycoplasma enters the internal genital organs, pain in the lower abdomen, in the lumbar region or anus may occur. The menstrual cycle is disturbed, intermenstrual bleeding is possible. With an advanced form of genital mycoplasmosis in women, "habitual" miscarriages or infertility are possible. Also, if a sick woman still managed to get pregnant, then stillbirth of the fetus or premature birth is not excluded. In this case, the child has a number of pathologies.

Diagnosis of urogenital mycoplasmosis

In order to correctly diagnose a urogenital infection of the genitourinary system, examination and laboratory methods of research are necessary. On examination, you can detect inflammatory changes, swelling, redness, erosion, soreness. This will lead the doctor to the idea that the presence of any microorganism is possible. For clarification, laboratory diagnostic methods such as:

Respiratory mycoplasmosis

Symptoms of respiratory mycoplasmosis

Initially, the symptoms of mycoplasmosis resemble influenza or another viral infection. There is an increase in body temperature to 37.5-38.5 ° C, a dry, hacking cough appears, there is a feeling of tickling in the throat, stuffy nose. A little later, after a few days, the infection goes down into the bronchi. In this regard, the cough intensifies, becomes unbearable and paroxysmal. Sometimes with a small amount of sputum. In the future, the lungs are involved in the process, mycoplasma pneumonia (pneumonia) occurs. Severe shortness of breath joins the above signs, and there may be streaks of blood in the sputum. With adequate and timely treatment, the subsidence of the disease processes occurs from 3 weeks to 3 months. For mycoplasmosis in patients with weak immunity, complications are characteristic in the form of meningitis (inflammation of the membranes of the brain), arthritis (damage to the joints), nephritis (inflammation of the kidneys). It is also possible to become chronic. In this case, it is necessary to periodically examine the patient for the development of bronchiectasis (pathological and irreversible airiness of the lungs and bronchial dilatation) and pneumosclerosis (replacement of normal lung tissue with connective, scar tissue).

Diagnosis of respiratory mycoplasmosis

In order to make a diagnosis of pulmonary mycoplasmosis, one X-ray of the lungs and a complete blood count (as with other types of pneumonia) are not enough. There are a number of methods for determining the pathogen in a patient:

Treating mycoplasmosis of the respiratory tract is a long and difficult procedure. The main drug is antibiotics. Apply mainly a group of macrolides (erythromycin, azithromycin, sumamed, clarithromycin). If it is impossible or ineffective to use them, there are reserve antibiotics (tetracyclines or fluoroquinolones). The duration of treatment is much longer than with other infections, reaching 21-25 days. In the first few days of illness, when the cough is still dry and painful, antitussive drugs (codterpin, stoptusin) are used. In the future, until the cough stops, expectorants (ambroxol, lazolvan, ACC) are used. At elevated temperatures, it is necessary to take antipyretics (paracetamol, ibuprofen, nimisulide).
In no case should you engage in self-medication, mandatory monitoring of treatment by a doctor is necessary.

Mycoplasma is considered the smallest form of organisms belonging to the mycoplasmataceae family. It is classified as a cross between unicellular organisms and multicellular viruses and bacteria. Despite this, scientists tend to think of them (mycoplasmas) as viruses more because they don't have a cell wall. In the mycoplasmataceae family, there are two genera of microorganisms, mycoplasma and ureaplasma, which can cause the development of a wide variety of diseases.

Causes of mycoplasmosis.
There are a lot of types of mycoplasmas, but only four of them, when favorable conditions are formed, can cause the development of mycoplasmosis and serious complications against this background. These include: mycoplasma genitalium, mycoplasma hominis, ureaplasma urealiticum, which cause urogenital diseases, and mycoplasma pneumonia, which serves as the causative agent of respiratory infections, affecting the bronchi, lungs and throat. It should be noted that mycoplasmas can be both opportunistic and absolutely pathogenic pathogens, in this case it all depends on the conditions.

Actually mycoplasmas, as a rule, are accompanied by various urogenital infections, as a result of which their diagnosis is very difficult. Mycoplasmosis in women in many cases develops against the background of a weakened immune defense, in most cases it is localized in the vagina, cervix and urethra. The waste products of these microorganisms lead to a toxic effect, which can cause damage to the epithelial layer of individual organs.

Respiratory mycoplasmosis.
This type of disease affects both parts of the respiratory system. The incubation period of the disease can be up to thirty days, often less. If there is a lesion of the upper respiratory tract, then this is usually rhinitis, if the lower ones, pneumonia occurs, accompanied by symptoms of intoxication, fever and chills. I must say that such pneumonia is resistant to penicillin drugs and their synthetic analogues. There are also complications of pneumonia in the form of pneumosclerosis or bronchiectasis.

Urogenital mycoplasmosis, symptoms.
Various infections (fungi, bacteria and viruses) provoke the development of this disease. The disease is often asymptomatic, with a high probability of developing acute infection or its transition to a chronic form with frequent relapses. The incubation period of the disease can reach fourteen days, but there are also more accelerated options (three to five days). Only occasionally the disease does not manifest itself. Factors such as fluctuations hormonal background, decreased immunity, hypothermia, pregnancy, etc. activate the activity of bacteria.

In women, urogenital mycoplasmosis is most often manifested by inflammation of the vaginal mucosa (vaginitis) or inflammation of the urethra (urethritis). The main signs of the disease are the appearance of yellowish or gray mucous secretions, pain in the lumbar region, irritation of the urethra (outside), and, as a result, itching and burning during urination, pulling pains in the lower abdomen, discomfort and pain during intimacy, various kinds of menstrual irregularities.

Mycoplasmosis in women, the danger of the disease.
Against the background of mycoplasmosis, serious diseases can develop, in particular, inflammation of the uterine appendages adnexitis, adhesions, cystitis, salpingitis, vaginitis, vaginosis or bacterial vaginosis (vaginal dysbacteriosis), pyelonephritis, endometritis and others. If a woman has at least one of the above diseases with an unexplained etiology, it is indirectly considered one of the symptoms of mycoplasmosis.

It should be noted that in the case of spontaneous, medical abortions, stillbirths, mycoplasma is detected during examination of a woman. Endometritis on the background of mycoplasmosis has symptoms of ordinary endometritis, and its complications, as a rule, are miscarriage and infertility.

Adnexitis against the background of mycoplasmosis provokes inflammation of the ovaries, which in turn can lead to abscesses and adhesion of the ovary to the fallopian tube.

Mycoplasmosis during pregnancy.
Pregnancy is a period when any existing infections can worsen in a woman’s body, as a result of which serious complications develop, in particular miscarriages, polyhydramnios, rupture of membranes against the background of progression of inflammation of the vaginal walls, and, as a result, premature birth. In most cases, during childbirth (when it passes through infected fallopian tubes), infection of the fetus (usually female) occurs.

Against the background of mycoplasmosis after delivery or artificial termination of pregnancy, the likelihood of developing endometritis is high.

When diagnosing mycoplasmosis during pregnancy, a woman should be treated. It is desirable to do this in the first three months, since in the future, medication can adversely affect the health and development of the fetus, causing the development various deviations, in the early stages, mycoplasmosis can provoke spontaneous miscarriage, placental abruption.

In addition, microplasma infection can cause ectopic pregnancy, make it difficult to conceive against the background of a violation of the process of egg maturation. This disease in a chronic form often leads to secondary infertility.

Diagnosis of mycoplasmosis.
Diagnosis of mycoplasmosis is difficult due to the very small size of the mycoplasma. Most often, for the diagnosis of the disease, the method of DNA research is used to identify the DNA of the pathogen (polymerase chain reaction method or PCR). This highly accurate method (up to 95%) is not suitable in the presence of purulent discharge. In this case, an ELISA procedure is prescribed (enzyme immunoassay method, the accuracy reaches about 70%) or bacteriological culture. Despite the low accuracy, the ELISA method is very fast (a couple of hours). A similar method of direct immunofluorescence (DIF) with the determination of mycoplasma antigens is also fast, inexpensive, but also of low accuracy. It takes a very long time to wait for the results of bakposev (a week), but today it is the most accurate (gives one hundred percent confidence in the presence or absence of mycoplasmas). The complexity of the method of bacteriological seeding is that mycoplasma requires a special nutrient medium. Also in the diagnosis of the disease using the study of smears on the flora.

It should be noted that the results obtained from the studies carried out may be false. Re-diagnosis should be carried out a month after the treatment course.

Mycoplasmosis in children.
Infection of a child with mycoplasma infection can occur by airborne droplets or in utero. Most often, the disease in children manifests itself in the form of pneumonia and bronchitis. In this case, if the cough symptoms do not disappear for a long time with the treatment of cough, it is necessary to consult a doctor, since this infection may occur. With untimely treatment, the disease can develop into bronchial asthma.

Mycoplasmosis in childhood spreads most often to the organs of the genitourinary and respiratory systems. Basically, these are the mucous membranes of the pharynx, lungs, nose, vagina (in girls), bronchi, bladder.

Mycoplasmosis treatment.
If the test for the presence of mycoplasma turned out to be positive, this does not mean the start of treatment. If there are pronounced signs of a gynecological or urological disease, which can be caused by mycoplasma, a smear study is prescribed for the types of pathogens. Treatment in the future will depend on the identified mycoplasmas and their accompanying infections.

Usually, treatment includes a whole range of activities. Among them, it is worth noting the appointment of antiprotozoal and antifungal drugs, immunotherapy (usually Cycloferon or Likopid), local therapy (candles, douching and instillation (irrigation) medicines urethra), physiotherapy, a specially selected diet. In addition, the chronic and complicated form of the disease is treated with broad-spectrum combined antibiotic preparations. The course of treatment is approximately ten days. Such treatment should be carried out by both partners, and during this period it is better to refuse sexual intercourse.

Remember! funds traditional medicine there is no cure for this serious disease!

Disease prevention.
The main prevention is selective sexual intercourse, the presence of one permanent and proven sexual partner, as well as the use of an additional means of protection during intercourse - a condom. When infected, it is important to undergo preventive treatment to prevent the development of the disease. When planning a pregnancy a few months before the intended conception, both partners must undergo a full course of examination.

Mycoplasmosis is a sexually transmitted infection that affects both men and women. With this disease, inflammation of the organs of the genitourinary system occurs. Mycoplasmosis is often asymptomatic and is discovered incidentally. Mycoplasmas are the smallest bacteria that live on plants and in the body of animals and humans. 16 types of mycoplasmas have been found in the human body. Of these, 6 species live on the mucous membranes of the genital organs and urinary tract; the remaining 10 species are in the mouth and pharynx. Mycoplasmosis is detected in 50-60% of patients suffering from chronic diseases of the genitourinary system. Mycoplasmas are detected in 5-15% of healthy individuals, which indicates the existence asymptomatic form infections.

More than 40 types of mycoplasmas are known to science, the danger to humans is: mycoplasma genitalium, mycoplasma hominis, mycoplasma pneumonia and ureaplasma urealiticum, which can cause:

• inflammatory diseases - mycoplasmosis (ureaplasmosis) - of the organs of the genitourinary system in men and women;
• pathology of pregnancy, fetus and newborn: non-developing pregnancy, miscarriages, premature births, early rupture of amniotic fluid, fever during childbirth and in the postpartum period in mothers. During childbirth, the baby may be infected, and he may develop eye damage, pneumonia. Newborn girls may develop mycoplasmosis of the genitourinary system;
• changes in the structure of spermatozoa cause male infertility;
• female infertility.

Activation of the asymptomatic form of mycoplasmosis is possible with a decrease in immunity against the background of hypothermia, stress, etc., and, most importantly, during pregnancy. That is why the examination for mycoplasma and ureaplasma are as mandatory as the examination for all sexually transmitted infections in preparing a woman for pregnancy.

Causes of mycoplasmosis

The causative agent of mycoplasmosis are mycoplasmas (Mycoplasma hominis, Mycoplasma genitalium). They are unique microorganisms that do not have a cell membrane (like bacteria), RNA and DNA. Mycoplasmas are similar in size to large viruses. Like viruses, they live and multiply inside cells, although they are not viruses.

How can you get mycoplasmosis

Mycoplasmosis can be contracted through sexual contact. Household infection is unlikely. In addition, during pregnancy, mycoplasmas can infect the fetus through vertical transmission, as well as transplacental. The frequency of vertical transmission of M. hominis ranges from 18 to 55% of infected mothers.

Risk Factors for Mycoplasmosis

• decreased immunity;
• abortions;
• transferred surgical operations;
• pregnancy and childbirth;
• infectious diseases.

Complications of mycoplasmosis

Mycoplasmosis is often the cause of the development of pelvic inflammatory processes in women - acute and chronic salpingitis, abscesses, parametritis, endometritis, adnexitis, etc. These infections pose the greatest danger to women during pregnancy (at all stages). They can cause abortion of the fetus, the formation of intrauterine infection.

Mycoplasmosis can lead to infertility in men, causing not only an inflammatory process, but also affect spermatogenesis and motor functions of spermatozoa.

Diagnosis of mycoplasmosis

The main method of diagnosis is culture - sowing on nutrient media. In addition, methods such as PCR (polymerase chain reaction) and ELISA (study of specific antibodies) are used. DIF (direct immunofluorescence) is also widely used in our country, but is characterized by relatively low accuracy (about 50-70%).

Due to the wide spread of inapparent mycoplasmal infection in healthy individuals, only a fourfold increase in antibody titer in paired sera obtained in the acute stage and in the convalescence stage can be considered diagnostically significant.

Symptoms of mycoplasmosis in women

In women, the symptoms of the disease are:

• Whitish liquid discharge from the genitals, which periodically appear, may be a symptom of mycoplasmosis.
• The occurrence of itching in the external genitalia with mycoplasmosis in women.
• In the middle or end of menstruation, pain may appear, and brown discharge before and after menstruation may also be observed, which may be symptoms of mycoplasmosis.
• The appearance of blood discharge with mycoplasmosis during the menstrual cycle.
• Burning during urination is the main symptom of mycoplasmosis in women.
• Pain during mycoplasmosis during sexual intercourse.

Symptoms of mycoplasmosis in men

In men, the symptoms of the disease are:

• clear discharge from the urethra;
• redness in the area of ​​​​the external opening of the urethra;
• itching, burning and pain when urinating;
• redness of the skin of the scrotum and pulling pains in the groin (with epididymitis).

If mycoplasmas infect the prostate gland, the symptoms of urogenital mycoplasmosis will be the same as with prostatitis. Nagging pain in the groin, perineum and scrotum occurs if the epididymis is infected. If the disease is started, the appendage will increase in size, and the skin of the scrotum will turn red. Mycoplasmosis not cured in time can adversely affect the process of sperm production.

Treatment of mycoplasmosis

It is necessary to treat mycoplasmosis, even if there are absolutely no manifestations of the disease. This infection is dangerous for pregnant women, since intrauterine damage to the fetus occurs, which very often leads to malformations of its development, miscarriages, premature birth and stillbirth.

Treatment of the disease should be comprehensive, and therapy is necessary not only for the patient, but also for her sexual partners. General and local drugs are used that act directly on mycoplasmas, as well as immunomodulators. The main group of drugs for the treatment of mycoplasmosis is antibiotics, preference is given to tetracycline drugs, macrolides and fluoroquinolones.

When choosing a specific drug, the doctor is guided by the results of the tests and the individual characteristics of the patient. Antibiotics should be taken strictly according to the prescribed scheme, the course of treatment lasts 7-10 days. Topically applied suppositories containing metronidazole, as well as preparations for douching:

• miramistin,
• chlorhexidine.

To prevent the development of a fungal infection, which often occurs during antibiotic treatment, antifungal drugs (fluconazole) are prescribed. When taking antibiotics, intestinal dysbacteriosis often occurs. For its prevention, patients are prescribed eubiotics - preparations containing lacto- and bifidobacteria:

• linex,
• normoflorin,
• bifidumbacterin.

Restoration of microflora, after local antibiotic therapy, is also necessary in the vagina. For this purpose, suppositories containing lactic acid bacteria are used:

• acylact,
• lactobacterin.

Since immunity is usually reduced in mycoplasmosis, patients need therapy aimed at strengthening the immune status. For this, patients are recommended to take multivitamin complexes:

• biomax,
• vitrum,
• alphabet, etc.

and preparations based on natural immunomodulators:

• echinacea purpurea,
• lemongrass,
• ginseng,
• eleutherococcus.

At the time of treatment, it is recommended to abstain from sexual intercourse, or use barrier methods of contraception. While taking antibacterial drugs, alcohol is prohibited. After completion of the course of therapy, it is necessary to undergo a follow-up examination to evaluate its effectiveness. 10 days after the end of taking systemic antibiotics, the gynecologist takes a smear for examination. A similar procedure is repeated 3 times in the middle of each subsequent menstrual cycle. Only if the result of bacteriological examination is negative in each smear, it can be considered that the person has been cured of mycoplasmosis.

Prevention of mycoplasmosis

• Refuse casual sex, especially without a condom;
• Before starting sexual activity with a certain person, a complete mutual examination for sexually transmitted diseases;
• Refusal of paid sexual services;
• Annual screening for sexually transmitted infections.

Questions and answers on the topic "Mycoplasmosis"

Question:Hello, I was born dead baby, the heart stopped during contractions. The other day I found out that I was pregnant again, for about 8 weeks, of course, it didn’t work out as planned, mycoplasmas were discovered before that, I hadn’t had time to be treated yet, but I really want a child. How big is the risk of the mycoplasmas themselves or the treatment for the child, and is it possible to keep the pregnancy at all?

Answer: Hello! Treatment of mycoplasmosis (if necessary) during pregnancy is carried out after 16 weeks. Regarding the risks for pregnancy and the fetus, everything depends on the clinical situation: whether or not there are clinical manifestations of mycoplasmosis, since in most cases mycoplasmosis, being a conditionally pathogenic microorganism, does not require treatment.

Question:Hello! I’m 30 years old, I’m worried about yellowish vaginal discharge with an unpleasant odor. I passed tests for genital infections, Mycoplasma genitalium was found, I drank a course of levofloxacin for 10 days. , Streptococcus agalactiae isolated, susceptible to ampicillin, azithromycin, cefotaxime, ceftriaxone, chloramphenicol, clindamycin, erythromycin, josamycin, levofloxacin, midecamycin, moxifloxacin, ofloxin, roxithromycin, spiramycin, vancomycin. What is the best antibiotic to take in my case? Thank you!

Answer: Hello. It is necessary to choose a drug from the list that is indicated as a result of the analysis.

Question:Good afternoon For the treatment of mycoplasmosis, my wife was prescribed tampons with tetracycline ointment. But it turns out that the ointment is 1% eye and 3% regular. The question is, which one do you need? And is it possible to make love during treatment (with a condom)? Thank you.

Answer: Good afternoon Ointment 3%, sex is strictly possible with a condom.

Question:My husband and I cannot have a child. My husband was diagnosed with urogenital mycoplasmosis and HPV. During my examination, nothing was found, the doctor did not prescribe anything for me for prevention. After the course of treatment, nothing was found in my husband, but his doctor insists that I undergo preventive treatment. What medications should I take for prophylaxis?

Question:Hello! I am 33 weeks pregnant. In the LCD, she took a smear and found Mycoplasma, prescribed azithromycin. I do not experience any clinical manifestations of mycoplasmosis. Before treatment, I would like to retake the analysis, tell me which one is right to take the analysis in the laboratory, so that it becomes clear whether treatment is necessary, and in general I would like to be examined correctly.

Answer: Hello! Mycoplasma is a conditionally pathogenic microflora and without clinical manifestations of mycoplasmosis, it does not require treatment.

At a gynecologist's appointment, even an absolutely healthy woman can get the results of tests in her hands, where mycoplasma is found. Conditionally pathogenic flora, which doctors take into account only under the condition of high titers, is quite common.

If the growth of the flora is very active and there are prerequisites for a decrease in the immune system, then a diagnosis is made - mycoplasmosis. Let's figure out what it is, and what methods of treatment can overcome these microorganisms.

Causes

Why does mycoplasma occur in women, and what is it? Mycoplasma is considered the smallest form of organisms belonging to the mycoplasmataceae family. It is classified as a cross between unicellular organisms and multicellular viruses and bacteria.

Despite this, scientists tend to think of them (mycoplasmas) as viruses more because they don't have a cell wall. In the mycoplasmataceae family, there are two genera of microorganisms, mycoplasma and ureaplasma, which can cause the development of a wide variety of diseases.

The source of infection is a person with a manifest or asymptomatic course of mycoplasmosis. The infection is transmitted by airborne droplets (with respiratory mycoplasmosis), sexual (with urogenital mycoplasmosis) and vertical (from mother to fetus - more often with urogenital mycoplasmosis) routes.

The incubation period of the disease is from 3 days to 5 weeks, on average 15-19 days.

Symptoms of mycoplasma in women

As a rule, the presence of mycoplasmas in the body is characterized by erased low-symptomatic forms. Approximately 10-20% of women do not feel any obvious symptoms of mycoplasma until a stressful situation, such as abortion or severe hypothermia, activates the infection, often leading to quite serious complications.

Urogenital mycoplasmosis in women it appears as:

• (gardnerellosis);
• mycoplasmal urethritis;
• inflammation of the uterus, fallopian tubes and ovaries;
• often mycoplasmosis is combined with and.

The insidiousness of mycoplasma in women is that the disease can be completely asymptomatic for many years. During this period, a woman is a carrier of the infection and can transmit it to her sexual partners.

Diagnostics

Diagnosis of urogenital mycoplasmosis is based on the PCR method (polymerase chain reaction), which determines the DNA of mycoplasmas. The classical cultural method is also used, with inoculation of the material on a liquid medium and subsequent transfer to a solid one.

Mycoplasmas are identified by colony fluorescence after the addition of specific anti-sera. Serological methods for detecting mycoplasmas are the complement fixation reaction (CFR) and the indirect agglutination reaction (IRGA).

As a material for laboratory research, women take a smear from the cervix, the vestibule of the vagina, the urethra and anus, the first morning portion of urine.

Treatment of mycoplasma in women

When diagnosing mycoplasma in women, the attending physician prescribes a treatment regimen consisting of complex therapy, including:

1. Antibacterial drugs(due to the resistance of mycoplasma to penicillin, antibiotics for mycoplasmosis are used from the tetracycline group, and macrolides are also used; the course of this treatment is up to 2 weeks);
2. Local treatment (candles, douching);
3. Immunomodulators (these drugs enhance the effect of drugs, they are used in the treatment of cycloferon or licopid);
4. Compliance with the diet recommended by the doctor;
5. Physiotherapy.

Unfortunately, the human body is not able to develop immunity to this infection, and therefore both sexual partners need to be treated with drugs at the same time. On average, the course of treatment for mycoplasmosis is 10 days. Then, after 2 or 3 weeks, the patient is assigned bakposev, and after 30 days - PCR.

Chronic form

In the treatment of chronic forms great importance acquires immuno-oriented and local therapy. The goal of immuno-oriented therapy is the correction of the immunodeficiency state, which has become the cause of the chronic course of the disease and has intensified against its background. It is prescribed taking into account the parameters of the immunogram.

Local therapy is carried out simultaneously with systemic antibiotic therapy, for 5-7 days. Usually, ethmotropic, anti-inflammatory drugs and enzymes (trypsin, chymotrypsin, etc.) are prescribed in the form of installations or using cotton-gauze swabs to treat the vagina. Immediately after its completion, it is recommended to undergo a course of treatment with probiotics to restore the microflora.

Consequences

A long course of mycoplasmosis without symptoms leads to the development of endometritis - inflammation of the uterine mucosa. Women with mycoplasmal endometritis have frequent miscarriages and missed pregnancies.

From the uterus, M. hominis and M. genitalium can spread to its appendages with development. Then adhesions appear in the tubes, which can lead to an ectopic pregnancy.