STD

Ureaplasma Urealyticum

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Ureaplasma Urealyticum, Ureaplasma Parvum

  • See Also
  1. Dysuria
  2. Sexually Transmitted Infection
  3. Ureaplasma
  4. Mycoplasma Genitalium
  • Pathophysiology
  1. Irregularly shaped Bacteria in the genus Mycoplasma, that lacks a cell wall (Penicillin resistant)
  2. Colonizes as well as causes symptomatic urogenital, oral and anal infections (sexually transmitted)
    1. Among normal vaginal flora in 60% of healthy sexually active women
    2. May infect the lower urinary tract resulting in Urethritis
  3. Four serovars (1, 3, 6, and 14) were previously classified as Ureaplasma Urealyticum (now classified as Ureaplasma Parvum)
  4. May be associated with Mycoplasma Genitalium infections
  • Risk Factors
  1. See Sexually Transmitted Infection
  2. HIV Infection
  • Symptoms
  1. Dysuria in Women
  2. Urethra may also have a small yellow mucoid discharge
  • Labs
  1. Difficult to culture (fastidious)
  2. Ureaplasma is urease positive
    1. Urease metabolizes urea into ammonia and carbon dioxide
    2. Urine pH may increase (7.5 to 8.5)
  3. Ureaplasma DNA PCR testing availability is increasing
    1. Urethal swabs are preferred
  • Differential Diagnosis
  1. See Urethritis in Women
  • Management
  1. Primary Antibiotic Regimens (adult dosing)
    1. Doxycycline 100 mg orally or IV every 12 hours for 7 to 14 days
  2. Alternative Antibiotic Regimens (adult dosing)
    1. Azithromycin 500 mg orally or IV for 10 to 14 days OR
    2. Levofloxacin 500 mg orally or IV daily for 10 to 14 days OR
    3. Moxifloxacin 400 mg orally or IV daily for 10 to 14 days
  • Complications
  1. Infertility secondary to pelvic infections (Pelvic Inflammatory Disease)
  2. Pregnancy loss or premature labor
  3. Neonatal Sepsis, Pneumonia and Meningitis may occur
  4. Other infections include Septic Arthritis, Osteomyelitis, Pneumonia, endocarditis
  5. Hyperammonemia Syndrome (Immunocompromised patients, esp. lung transplant)
    1. Tantengco (2021) Clin Transplant 35(7):e14334 +PMID: 33948993 [PubMed]
  • References
  1. (2024) Ureaplasma Urealyticum, Sanford Guide, accessed on IOS, 5/5/2024