Immunsupprimert kvinne i 20-årene med magesmerter og utflod

Refractory Bilateral Tubo-Ovarian Abscesses in a Patient with Iatrogenic Hypogammaglobulinemia

“…Our case is similar to three prior reports of severe U. urealyticum infection in women <30 years old on chronic rituximab therapy for the management of MS (2 cases) [9,13] and granulomatosis with polyangiitis (GPA) (1 case) [10]. Kvalvik et al (2020) published a case almost identical to ours: a woman in her early twenties with MS, presenting with fever and progressive abdominal pain, was found to have bilateral TOAs [9]. U. urealyticum was identified as the causative agent in all case studies through urine culture [13], a PCR of respiratory and urinary samples [10], and pus analysis [9], and was responsive to treatment with doxycycline.…”

“…The literature on Ureaplasma infections signals a strong relationship between humoral immunodeficiency and invasive spread [13,23]. Our case is similar to three prior reports of severe U. urealyticum infection in women <30 years old on chronic rituximab therapy for the management of MS (2 cases) [9,13] and granulomatosis with polyangiitis (GPA) (1 case) [10]. Kvalvik et al (2020) published a case almost identical to ours: a woman in her early twenties with MS, presenting with fever and progressive abdominal pain, was found to have bilateral TOAs [9].…”

“…Herein, we present a case of refractory, bilateral tubo-ovarian abscesses (TOAs) caused by U. urealyticum in a nonpregnant hypogammaglobulinemic female of reproductive age. To our knowledge, only one similar case has been reported [9], and this organism is not considered an established cause of TOA.…”

“…Nonetheless, it is important to consider how the risk-benefit tradeoff for testing and treatment shifts in the setting of immunosuppression. There have been multiple case studies of U. urealyticum infections in immunocompromised children and adults in the setting of hematologic malignancy [8], autoimmune disease [9,10], and organ transplant [11,12]. The majority of these cases are reported in patients with congenital or iatrogenic hypogammaglobulinemia [13].…”

Immunocompromised teenager with meningitis caused byUreaplasma parvum

“…Patients with humoral immunodeficiency—both primary and acquired—seem particularly at risk. In the past three decades, seven cases of invasive Ureaplasma disease have been reported in patients with common variable immunodeficiency/agammaglobulinaemia, in 1 patient with the immunodeficiency disorder Good’s syndrome14–20 and in at least 19 cases of patients receiving B-cell depletion therapy with rituximab 12 21–38. Hypogammaglobulinaemia is frequently observed in patients treated with rituximab 39 40…”