Chronic Cystitis and Urethritis Associated with Ureaplasmal and Mycoplasmal Infection in Primary Hypogammaglobulinaemia

Abstract

Six of 58 patients with primary hypogammaglobulinaemia developed chronic urethritis and/or cystitis. We have some evidence that this complication may be caused by infection with strains Rof Ureaplasma urealyticum. This is important because ureaplasmas are usually resistant to most antibiotics routinely used to treat lower urinary tract infections. It appears that hypogammaglobulinaemic patients develop less localised and more severe ureaplasmal infections than immunocompetent subjects, which indicates that antibodies are important in controlling the growth of these organisms in the bladder and urethra.

International Consensus Document (ICON): Common Variable Immunodeficiency Disorders

“…58 Arthritides and lung infections may also be caused by Ureaplasma or Mycoplasma organisms, and these should be considered when other common pathogens are not found. 59–61 Enteroviral infections may cause meningoencephalitis or a dermatomyositis-like syndrome in undiagnosed patients not receiving IgG, or in those who are receiving lower (inadequate) doses (0.1–0.3 g/kg/month).…”

“…58 In the case of urogenital infections, it may often be useful to treat the patient’s partner as well. Mycoplasma in joints or lungs may require intravenous antibiotics.…”

A case of an Ureaplasma infection causing significant soft tissue destruction to the vagina, perineum and abdominal wall in a patient with hypogammaglobulinemia

“…Extragenital infection is rare and often in the context of underlying immunosuppression [4] or a prosthetic device. Site of infection may include; arthritis, meningitis, brain abscess, sternal wound infection, mediastinitis and aortic graft infection and an abscess in a transplanted kidney (Jof Infection Ref) [5][6][7][8]. However, their role in localized genital disease is still unclear given their low pathogenic potential and high background prevalence.…”

Ureaplasma urealyticum causing persistent urethritis in a patient with hypogammaglobulinaemia.

“…The special conditions provided by hypogammaglobulinaemia, however, enable these organisms and other mycoplasmas to invade and cause septic arthritis, 6 7 and we have drawn attention already to the occurrence of chronic cystitis and urethritis associated with the isolation of genital mycoplasmas in patients with hypogammaglobulinaemia. 8 We present now a more detailed account of the clinical and microbiological events that occurred in a patient with hypogammaglobulinaemia who developed NGU. These details suggest strongly that U urealyticum was a cause of the urethritis.…”