Cervicitis necrótica por co-infección de virus herpes simplex 2 y Mycoplasma genitalium / Necrotic cervicitis for co-infection of herpes simplex virus 2 and Mycoplasma genitalium

Resumen Las cervicitis es una condición frecuente causada principalmente por agentes de transmisión sexual. Su presentación clínica varía desde cuadros asintomáticos hasta procesos inflamatorios extensos, que incluso asemejan un tumor maligno. Presentamos el caso de una adolescente que presentó úlceras genitales, síntomas generales y cérvix necrótico con aspecto tumoral. Los estudios de laboratorio confirmaron una co-infección por virus herpes simplex 2 (HSV-2) y Mycoplasma genitalium. El estudio histológico descartó una neo- plasia. Evolucionó favorablemente al tratamiento antimicrobiano, con recuperación progresiva del aspecto del cérvix. La cervicitis en raras ocasiones se presenta con compromiso necrótico. La co-infección por HSV-2 y M. genitalium, en este caso, pudo ser el determinante del daño cervical y la necrosis. Una evaluación acuciosa y estudio con exámenes diagnósticos de alta sensibilidad y especificidad permitieron hacer un diagnóstico y tratamiento adecuado.

Abstract Cervicitis is a frequent condition caused mainly by sexually trans- mitted agents. The clinical spectrum varies from absence of symptoms to extensive inflammatory processes that may simulate a malignant neoplasm. We present a clinical case of an adolescent with genital ulcers and systemic disease. Speculoscopy revealed a tumoral-looking cervix. Laboratory studies confirm infection with herpes simplex virus 2 (HSV-2) and Mycoplasma genitalium, together with a histological study that ruled out neoplasia. It progresses favorably to antimicrobial treatment, with recovery of the appearance of the cervix. Cervicitis rarely presents with necrotic involvement. Co-infection with HSV-2 and M. genitalium infection may have been the determinant of cervical damage and the necrotic appearance. A thorough evaluation and study with highly sensitive and specific diagnostic tests allowed an adequate diagnosis and treatment.

Prevalence and Antibiotic Susceptibility of Mycoplasma hominis and Ureaplasma urealyticum in Pregnant Women

Mycoplasma hominis (M. hominis) and Ureaplasma urealyticum (U. urealyticum) are important opportunistic pathogens that cause urogenital infections and complicate pregnancy. The aim of this study was to investigate the prevalence, effects on pregnancy outcomes, and antimicrobial susceptibilities of M. hominis and U. urealyticum. We tested vaginal swabs obtained from 1035 pregnant women for the presence of genital mycoplasmas between June 2009 and May 2014. The laboratory and clinical aspects of genital mycoplasmas infection were reviewed retrospectively, and the identification and antimicrobial susceptibility of genital mycoplasmas were determined using the Mycoplasma IST-2 kit. A total of 571 instances of M. hominis and/or U. urealyticum were detected. Of them, M. hominis was detected in two specimens, whereas U. urealyticum was detected in 472 specimens. The remaining 97 specimens were positive for both M. hominis and U. urealyticum. Preterm deliveries were frequently observed in cases of mixed infection of M. hominis and U. urealyticum, and instances of preterm premature rupture of membrane were often found in cases of U. urealyticum. The rates of non-susceptible isolates to erythromycin, empirical agents for pregnant women, showed increasing trends. In conclusion, the prevalence of M. hominis and/or U. urealyticum infections in pregnant women is high, and the resistance rate of antimicrobial agents tends to increase. Therefore, to maintain a safe pregnancy, it is important to identify the isolates and use appropriate empirical antibiotics immediately.

Meningoencephalitis associated with Mycoplasma pneumoniae / Meningoencefalite associada ao Mycoplasma pneumoniae

We report a case of a child with meningoencephalitis of atypical etiology. The patient developed the disease after an infection in the upper airways with unfavorable evolution. The clinical recovery was only possible after the administration of adequate antibiotic therapy for the etiological agent. This case report describes a child with meningoencephalitis of atypical etiology. The patient developed the disease after an infection in the superior airways with negative evolution. The clinical recovery was possible only after the introduction of adequate antibiotic therapy for the etiological agent.

Este relato de caso descreve uma criança com menignoencefalite de etiologia atípica. A paciente desenvolveu a doença após infecção de vias aéreas superiores, com evolução desfavorável. Houve recuperação clínica somente após introdução de antibioticoterapia adequada para o agente etiológico.

Manifestaciones muco-cutáneas de la infección por Mycoplasma pneumoniae: Presentación de cuatro casos / Mucocutaneous findings of the Mycoplasma pneumoniae infection: Presentation of four cases

The mucocutaneous manifestations oí Mycoplasma pneumoniae infection appear in approximately 20 percent of all the infections produced by this microorganism. Maculopapular rash, vesicular or urticarial exanthemas, are frequent manifestations that can constitute Erythema multiforme or more rarely, Stevens - Johnson syndrome or epidermal toxic necrolisis. We describe the clinical evolution, diagnosis and treatment of four children with mucous and cu-taneous manifestations associated to infection by Mycoplasma pneumoniae and a review of the medical literature.

El compromiso muco-cutáneo de la infección por Mycoplasma pneumoniae se presenta en aproximadamente 20 por ciento de todas las enfermedades producidas por este microorganismo. Frecuentemente se manifiesta con lesiones máculo-papulares, vesiculosas o urticariales, que pueden constituir el eritema multiforme, más raramente síndrome de Stevens-Johnson o necrosis epidérmica tóxica. Describimos la evolución clínica, diagnóstico y el tratamiento administrado a cuatro niños que presentaron manifestaciones de piel y mucosas en relación a la infección por Mycoplasma pneumoniae. Se efectuó además una revisión de la literatura médica.

Isolation of Mycoplasma bovoculi from genitally diseased bovines and its experimental pathogenicity in pregnant guinea pigs.

Thirteen strains of M. bovoculi, 6 from frozen bull-semen (3.5% of 168), 3 from neat bull-semen (3.0% of 100), one each from heart blood and stomach contents of aborted foetus of 85 (1.18%) bovine-abortions, one each from stomach contents and pooled internal organs of 9 (11.1%) stillborn calves, were isolated. All the isolates were resistant to ampicillin and sensitive to spiramycin, vibramycin, demeclocyclin, oxytetracycline, lincomycin and tylosin. However, variation in resistance to tetracycline, erythromycin, neomycin, kanamycin and streptomycin was observed. The gross lesions like congestion of lungs, liver, kidney and spleen were noted only in stillborn calf. However, significant microscopic lesions were encountered in internal tissues of both the aborted bovine fetuses and stillborn calf. Thickened alveolar wall, congestion of blood vessels, mesenchymal cell proliferation along with infiltration of lymphocytes and macrophages were observed in lungs. The liver showed mild infiltration of lymphocytes, macrophages in hepatic triad and necrosis of hepatic cells. The kidney tissues had focal lymphocytic infiltration in the interstitium. One strain of M. bovoculi (isolate # SBC-7/84,IO) isolated from a stillborn calf was found abortigenic upon experimental inoculation in pregnant guinea pigs.

Esparfloxacino e as fluorquinolonas: uma revisäo de sua classificaçäo, atividade antibacteriana, mecanismo de açäo, características farmacocinéticas, tolerabilidade e perspectivas farmacêuticas / Sparfloxacin and the fluoroquinolones: a review of classification, antibacterial activity, mechanism of action, pharmacokinetic properties, tolerability and pharmaceutical perspectives

Foi realizada uma revisäo na literatura sobre as quinolonas, classe antibacteriana que possui amplo espectro de açäo, enfocando, principalmente, o esparfloxacino, fluorquinolona de terceira geraçäo que possui potente atividade contra bactérias Gram-positivas, como Streptococcus pneumoniae e Staphylococcus aureus inclusive cepas metilina resistentes (MRSA), bactérias Gram-negativas, anaeróbios, Legionella spp, Mycoplasma spp, Chlamydia spp e Mycobacterium spp.

Infección por Mycoplasma Pneumoniae: estudio en 46 pacientes pediátricos en el Hospital La Victoria (Bogotá)

La infección respiratoria aguda es una de las causas de morbi-mortalidad en el país y en el mundo; dentro de los agentes etiólogicos de esta entidad encontramos el Mycoplasma Pneumoniae, patógeno de los seres humanos, que produce principalmente infeccion respiratoria grave en niños mayores y adultos jovenes (neumonia atípica), aunque la enfermedad más leve aparece en lactantes menores y niños pequeños, situación que dificulta en ocaciones el diagnostico y por ende el manejo de la misma. A continuación se presenta una serie de 46 pacientes, (su sintomatologia y su signologia) a los cuales se les diagnostico neumonia por Mycoplasma en el Hospital De La Victoria, al suroriente de Bogotá en periodo comprendido entre 1989 y 1993. durante el presente estudio se realizó una comparación entre los hallazgos obtenidos por los autores y los encontrados en otras series internacionales

Doxycycline treatment in mycoplasma and ureaplasma urinary tract infections

Mycoplasma hominis [M. hominis] and Urea plasma urealyticum [U. urealyticum] were documented to play a significant role in recurrent urinary tract infections [UTI] in Egyptian patients especially when associated with urinary schistosomiasis. Doxycycline is the drug of choice used to treat these infections at TBRI [100 mgtwice daily for 2 weeks] and this study was conducted to evaluate its efficacy. Fifty six patients with M. hominis and/or U. urealyticum UTI were included and classified into two groups according to association with urinary schistosomiasis. Cure rates of 39.4% and 34.8% were achieved after one course of treatment in group [I] [schistosomal] and in group [II] [non-schistosomal] patients respectively. Higher rates were achieved after a second course of doxycycline in resistant cases [88% and 91% respectively] Test-of-cure cultures obtained 10-15 days after completion of therapy showed treatment failure in only 6 patients [10.9%], four of them had urinary tract stones and their urine samples grew U. urealyticum, three of these patients were schistosomal. It is concluded that a high cure rate [89%] could be achieved by repeating the doxycycline course. Patients with urinary stones should be managed operatively before successful doxycycline therapy

Aspectos clínico-microbiológicos del Ureplasma urealyticum / Clinic and microbiological aspects of Ureoplasma urealyticum

Los micoplasmas revisten gran importancia clínica, por haberse reconocido su papel patógeno en entidades clínicas como neumonía atípica primaria, uretritis no gonocócica e infecciones cervicovaginales de la mujer en etapa sexual activa. En Europa durante el siglo XVIII, se presentó en el ganado una enfermedad pulmonar altamente contagiosa, a la cual se denominó pleuroneumonía. Sin embargo, fue hasta 1898 cuando Nocard y Roux lograron aislar el agente causal de esta enfermedad sin saber que se trataba de Mycoplasma mycoides. Las colonias poducidas en el medio de cultivo, se apreciaban muy pequeñas, pleomórficas y se teñían débilmente con los colorantes habituales. Con el paso del tiempo se siguieron observando algunos gérmenes, cuya morfología y propiedades de cultivo eran semejantes. Las fuentes de estos aislamientos fueron muy diversas. Al principio y de manera abreviada se les denominó PPLO (Pleuropneumoniae like organisms) por su similitud con agentes productores de pleuroneumonía bovina

Incidencia del Mycoplasma genital en la consulta de fertilidad / Occurence of genital Mycoplasma in fertility consultation

Se realiza un estudio en 77 pacientes provenientes de la Consulta de Esterilidad para determinar la incidencia de la infección genital por mycoplasma en nuestro medio hospitalario y su responsabilidad en los problemas de fertilidad. A cada paciente se le tomaron muestras de vagina y del endocervical y se sembraron en cultivos especiales para ello. Los resultados obtenidos se compararon con un grupo de 38 pacientes con fertilidad comprobada, obteniéndose un alto porcentaje de cultivos positivos: 64,94%. El ureplasma urealiticum fue el género que más se aisló. De importancia es su localización endocervical; las pacientes con cultivos positivos para mycoplasma genital se trataron con doxiciclina según esquema presentado; las parejas también fueron tratadas. Observamos un alto índice de embarazos comprobados por clínica, gonadotropina y ecosonograma. Nuestra estadística se comparó con la de otros autores y observamos resultados similares. Siempre que se realice un plan de estudio para pacientes de las Consultas de Fertilidad, debe tomarse en cuenta la investigación del mycoplasma genital y tratarlo si se encuentra positivo