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1/11. Clinical and biological characteristics of ureaplasma urealyticum induced polyarthritis in a patient with common variable hypogammaglobulinaemia.

    Persistent infectious polyarthritis caused by ureaplasma urealyticum in a patient with common variable hypogammaglobulinaemia is described. The patient developed a symmetrical, destructive polyarthritis and tenosynovitis associated with a markedly depressed synovial fluid glucose concentration and characteristic soft tissue abscesses. The ureaplasma organism developed resistance to multiple antibiotics and persisted for five years. The organism was identified repeatedly in many joints by culture, confirmed by dna hybridisation, and mycoplasma-like structures were shown in synovial tissues by electron microscopy. ( info)

2/11. Wound infections after cesarean section with mycoplasma hominis and ureaplasma urealyticum. A report of three cases.

    mycoplasma hominis and ureaplasma urealyticum were isolated from the surgical wounds of three patients who developed endometritis and a wound infection after cesarean section. In all patients, aspiration of the incision yielded a cloudy serosanguinous exudate. Gram stain of the fluid revealed numerous white blood cells but no bacteria. All patients responded to antibiotic therapy and local wound care. ( info)

3/11. Septic osteomyelitis and polyarthritis with ureaplasma in hypogammaglobulinemia.

    We describe a hypogammaglobulinemic woman with a one-year history of destructive septic osteomyelitis and polyarthritis with positive cultures for ureaplasma urealyticum from joint exudate and blood. The clinical course was complicated by subcutaneous abscesses from which both U. urealyticum and mycoplasma hominis were grown. Multiple routine cultures had been negative, except for sporadic findings of staphylococcus epidermidis before specific cultures for mycoplasmas were performed. Therapy with beta-lactam antibiotics, clindamycin, rifampicin, fusidic acid and aminoglycosides had been given without obvious clinical effect. Intravenous doxycycline treatment instituted after microbiological diagnosis had a dramatic effect on the clinical course. The clinical suspicion of mycoplasma and ureaplasma as etiologic agents of orthopaedic infections in hypogammaglobulinemic patients is mandatory in order to perform appropriate cultures. ( info)

4/11. Chronic orbital inflammatory disease: parasitisation of orbital leucocytes by mollicute-like organisms.

    Chronic orbital inflammatory disease (COID) is usually considered non-infectious and idiopathic. Treatment is empirical, palliative, and may not prevent disease progression. COID occurs in isolation or in association with various systemic diseases. exophthalmos may be an important presenting sign. vasculitis, lymphoid infiltrates, and granulomas are common. Mollicute-like organisms (MLO) parasitising and destroying vitreous leucocytes are often found to cause human chronic uveitis when an appropriate search is made. Inoculation of these MLO into mouse eyelids produced chronic uveitis and exophthalmic orbital inflammatory disease. Mollicutes are cell wall deficient bacteria. Extracellular mollicutes cause human and animal diseases characterised by lymphoid infiltrates, immunosuppression, and autoantibody production. Intracellular morphologically similar bacteria are non-cultivable pathogens termed MLO. Identification is based on direct detection in diseased cells by transmission electron microscopy. MLO are cytopathogenic and detection is aided by the alterations they produce. MLO replace the cytoplasm, destroy the organelles, and alter the nucleus. This results in cell proliferation, destruction, and dysfunction. MLO parasitise lymphocytes, monocytes, and polymorphonuclear leucocytes. This report describes orbital leucocytes parasitised by MLO in three patients with isolated COID. Rifampicin treatment of MLO disease is discussed. ( info)

5/11. Infection of the epididymis by ureaplasma urealyticum.

    ureaplasma urealyticum organisms (ureaplasmas) were isolated from the urethra and epididymal aspirate of a man aged 24 who had acute right sided epididymitis. No other microorganisms were detected, and he had no chlamydial antibody response. A fourfold antibody response to the epididymal ureaplasma isolate was detected by two methods, however, and the patient responded clinically to doxycycline, to which the ureaplasmal isolates were susceptible in vitro. These findings suggest that U urealyticum had a causative role. ( info)

6/11. Rapidly recurrent renal calculi caused by ureaplasma urealyticum: a case report.

    We report on a patient operated upon 8 times for recurrent bilateral struvite stones. Multiple conventional bacterial cultures had been negative. No etiological agent for the rapidly recurring concrements could be detected until ureaplasma urealyticum cultures were performed at the time of the seventh operation. ureaplasma urealyticum was found in the bladder and renal pelvic urine, and in the stones. That operation was followed by appropriate antibiotic treatment (doxycycline), which eradicated the microorganism and no stones recurred for 6 months. The urinary pH, which constantly had been highly alkaline before treatment, was normal as was the ammonium loading test. However, 1 year after the seventh operation the Ureaplasma infection recurred, probably due to sexual transmittance, and a new renal stone was discovered. These findings strongly suggest that ureaplasma urealyticum can induce the formation of infection concrements. ( info)

7/11. cystitis with ureteral reflux caused by ureaplasma urealyticum.

    The authors present a case of a fifteen-year-old boy with urgency, suprapubic pain, hematuria, and pyuria with negative routine urine cultures. cystoscopy revealed gross cystitis, and VCUG showed bilateral reflux and ureteral dilatation. Renal arteriograms, percutaneous renal biopsy, and bladder biopsy also were performed. After finding a positive culture for Ureaplasma, therapy with doxycycline rendered the patient asymptomatic and reflux improved on follow-up VCUG. ureaplasma urealyticum should be considered in patients with symptomatic pyuria and negative routine cultures. Ureteral reflux, reversible with appropriate therapy, may be part of the infectious process. ( info)

8/11. Ureaplasma-infected human sperm in infertile men.

    The case of an infertile man with oligospermia and symptoms of urethritis-prostatitis, whose spouse had a vaginal discharge, is reported. Microbiological analysis of appropriate specimens revealed a strain of tetracycline-resistant ureaplasma urealyticum in both patients. Using the transmission electron microscope, it was possible to demonstrate spermatozoal heads "infected" with microorganisms strongly resembling ureaplasma urealyticum. ( info)

9/11. Transmission of ureaplasma urealyticum by artificial insemination by donor.

    A case of U. urealyticum transmitted by AID is described. To prevent this complication, the donor must be screened with cultures not only for N. gonorrhoeae but also for U. urealyticum and chlamydia. Despite the poorer results with frozen sperm, cultures for sexually transmitted disease may in the long term result in fewer reproductive failures and less morbidity. ( info)

10/11. Haematuria associated with ureaplasma infection in sickle-cell trait.

    Phase-contrast microscopy of the urine of a young Greek woman with macroscopic haematuria showed sickling of the red blood cells. The diagnosis of sickle-cell trait was confirmed with haemoglobin electrophoresis, and an intravenous pyelogram demonstrated the typical medullary cavities seen in this disease. urine collected from the left ureter, from which the haematuria originated, grew 10(6) ureaplasma urealyticum/ml. With doxycycline therapy the macroscopic haematuria and the sickled cells in the urine resolved, but red cell casts and an excessive number of glomerular red blood cells persisted in the urine, confirming the presence of glomerulonephritis. ureaplasma urealyticum has not previously been described in association with a sickling episode nor with the scarring of a sickle cell kidney. The possible role of this infection is discussed. ( info)
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