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Sexually active young adults in the small college town of La Crosse, Wisconsin, were evaluated for conventional sexually transmitted pathogens and tested for infections with mycoplasmas. The prevalence in 65 symptomatic men or women and 137 healthy volunteers (67 men and 70 women) was compared. Urine specimens from both cohorts were tested by ligase chain reaction for Chlamydia trachomatis or Neisseria gonorrhoeae. In addition, the urethral or cervical swabs from the symptomatic subjects were tested by PCR for Mycoplasma genitalium and cultured for Mycoplasma hominis and the ureaplasmas. The results confirmed a relatively low prevalence of gonorrhea among symptomatic men (12%) and chlamydia among symptomatic men (15%) and normal women (3%). In contrast, infections with mycoplasmas, especially the ureaplasmas (57%), were common and the organisms were the only potential sexually transmitted pathogen detected in 40 (62%) symptomatic subjects. Because of the high prevalence, we also evaluated urethral swabs from an additional 25 normal female volunteers and recovered ureaplasmas from 4 (16%) subjects. Additionally, the participants rarely used protection during sexual intercourse and some symptomatic subjects apparently acquired their infections despite using condoms regularly. The findings demonstrate a strong association between abnormal urogenital findings and detection of myoplasmas, particularly ureaplasmas, and suggest the infections will remain common.Genitourinary infections, including sexually transmitted diseases (STDs), are caused by a large number of diverse microbial agents that cause considerable morbidity and mortality worldwide. While "classical" sexually transmitted pathogens such as Neisseria gonorrhoeae and Treponema pallidum continue to produce serious illnesses among certain (primarily urban) populations in the United States (6, 7), less urbanized communities have a proportionally higher incidence of urethritis and cervicitis caused by Chlamydia trachomatis. In addition, mycoplasmas commonly colonize the genital tracts of men and women (34), and the ability of some species to cause nongonococcal urethritis has been well established. However, the prevalence and complete pathogenic potential of this bacterial group is still being elucidated (2,4,34,35).La Crosse, Wisconsin, a small city with a relatively large number of college students, has a low incidence of gonorrhea and syphilis. In addition, the incidence of C. trachomatis infections declined until 1997, though it has increased in recent years. This may be due in part to the introduction of more sensitive DNA-based assays. The countywide annual incidence of Chlamydia was 247/100,000 in 2001 (La Crosse County Public Health data). More significantly, a large proportion of urethritis and cervicitis cases remain nongonococcal and nonchlamydial, and we hypothesized a significant contribution from genital mycoplasmas. Accordingly, we evaluated a cohort of sexually active young adults with clinical symptoms suggestive of STD (i.e., urethritis or cer...

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The American Civil War represents a landmark in military and medical history as the last large-scale conflict fought without knowledge of the germ theory of disease. Unsound hygiene, dietary deficiencies, and battle wounds set the stage for epidemic infection, while inadequate information about disease causation greatly hampered disease prevention, diagnosis, and treatment. Pneumonia, typhoid, diarrhea/dysentery, and malaria were the predominant illnesses. Altogether, two-thirds of the approximately 660,000 deaths of soldiers were caused by uncontrolled infectious diseases, and epidemics played a major role in halting several major campaigns. These delays, coming at a crucial point early in the war, prolonged the fighting by as much as 2 years.