Contents
1. Etiology
Pathogens:
- Ureaplasma urealyticum/parvum
- Mycoplasma hominis/genitalium
Key features: - Smallest free-living bacteria
- Lack cell walls
- Ureaplasmas hydrolyze urea
- Mycoplasmas cause more aggressive infections
2. Transmission
- Sexual (primary route)
- Vertical (mother to fetus)
- Household contact (very rare)
3. Symptoms
In men:
- Mucoid discharge
- Dysuria
- Perineal discomfort
- Epididymo-orchitis (rare)
In women:
- Mild discharge
- Dyspareunia
- Intermenstrual bleeding
- Cervicitis/vaginitis
Special risks:
- Pregnancy loss
- Postpartum complications
- Infertility (chronic cases)
4. Diagnosis
- PCR (genital swabs)
- Culture with titer determination
- ELISA (antibodies)
- Microscopy (indirect signs)
Diagnostic criteria:
- Titer >10^4 CFU/ml
- Clinical manifestations
- Ruling out other STIs
5. Prevention
- Barrier contraception
- Routine screening
- Preconception care
- Immune support
6. Treatment
Protocols:
- Doxycycline (100 mg bid, 10 days)
- Josamycin (500 mg tid, 10 days)
- Azithromycin (for M. genitalium)
Key notes:
- Treat only symptomatic cases
- Mandatory partner treatment
- Follow-up at 1 month
7. Clinical Recognition
Warning signs:
- Chronic genitourinary inflammation
- Unexplained infertility
- Pregnancy complications
- Treatment resistance
8. Post-Exposure Management
- Genital hygiene
- Medical consultation
- Testing after 2 weeks
- Prophylactic treatment not advised
9. Identifying Potential Cases
Indicators:
- Persistent urethritis/vaginitis
- Conception difficulties
- Recurrent cystitis
- Failed standard therapies
