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Chlamydia, Mycoplasma and Ureaplasma

WHAT THEY ARE: Mycoplasma, chlamydia and ureaplasma are among the smallest organisms. They are unlike other bacteria because they have no cell walls and therefore must live inside cells. They are unlike viruses because they can live in cultures outside of cells and can be killed by certain antibiotics. However, they cannot be killed by most antibiotics, as most antibiotics work by damaging a bacteria's cell wall. They can be killed by antibiotics such as the tetracyclines or erythromycins that do not act on a cell wall.

WHAT DISEASES THEY CAUSE: If you feel sick and your doctor is unable to make a diagnosis because all laboratory tests and cultures fail to reveal a cause, you could be infected with any of these bacteria. The only way that you will be cured is for your doctor to suspect an infection with these germs and for you to take long-acting erythromycin or tetracyclines for several weeks, months or years. They are the most common cause of venereal diseases and are a common cause of muscle and joint pains, burning in the stomach, a chronic cough, and chronic fatigue. They can cause transverse myelitis (paralysis of the spine) (1); gall stones (2); a chronic sore throat (3); red itchy eyes, pain on looking at light and blindness (4); arthritis (5,19); brain and nerve damage with symptoms of lack of coordination, headaches and passing out; spotting between periods or uterine infections (6); kidney stones (7); testicular pain; asthma (8); heart attacks (9); strokes (10); cerebral palsy (11); premature birth (12); high blood pressure (13); nasal polyps (14); stuffy nose in newborns (15); chronic fatigue (16); belly pain (17); muscle pain (18); confusion, passing out and death (19); coughing, bloody diarrhea, and anal itching and bleeding.

WHY THEY ARE SO DIFFICULT TO DIAGNOSE AND TREAT: Most doctors will not prescribe antibiotics to patients without a laboratory test that indicates a specific infection. No dependable test is available to rule in or out mycoplasma, chlamydia or ureaplasma infections. Most antibiotics will not kill these organisms and those that do have to be taken for many months and years. Furthermore, many infected people do not take medication long enough to be cured, or they may have a close contact with an infected person and become reinfected. Once these infections are allowed to persist for months or years, they are extraordinarily difficult to cure and often require treatment for many months. One venereal-disease patient in four takes medication as prescribed (20) and almost all women who still had chlamydia one month after treatment were reinfected by new or old partners (21).

Usually your first symptoms from chlamydia, ureaplasma and mycoplasma are burning on urination, a feeling that you have to urinate all the time, terrible discomfort when the bladder is full and vaginal itching, odor or discharge. Other first symptoms include itchy eyes, a cough or a burning in your nose. You can be infected when an infected person coughs in your face, or you touch nasal or eye secretions from an infected person and put your finger in your nose or eye. Your chances for a cure are high if you are treated when you have only local symptoms; but after many months, the infection can spread to other parts of your body and make you sick or damage nerves, joints and muscles. If you feel sick and your doctor is unable to make a diagnosis because all laboratory tests and cultures fail to reveal a cause, you could be infected with mycoplasma, chlamydia or ureaplasma and can be cured only by taking long-acting erythromycin or tetracyclines for many months.

HOW I TREAT: I often prescribe 500 mg of azithromycin twice a week and/or doxycycline 100 mg twice a day. You may require treatment for months or years, if your symptoms have gone on for many months or years: muscle and joint pains, a chronic cough, burning on urination, severe fatigue or signs of nerve damage. However, long term treatment with antibiotics is controversial and many physicians disagree with these recommendations. Discuss your particular condition with your doctor or health care provider. For more information on some of the diseases and conditions that may be caused by these bacteria, see my reports on asthma, heart attacks, infertility, venereal disease, reactive or rheumatoid arthritis, and fibromyalgia.

1) M Abelehorn, W Franck, U Busch, H Nitschko, R Roos, J Heesemann. Transverse myelitis associated with Mycoplasma pneumoniae infection. Clinical Infectious Diseases 26: 4 (APR 1998):909-912.

2) N Figura, F Cetta, M Angelico, G Montalto, D Cetta, L Pacenti, C Vindigni, D Vaira, F Festuccia, A Desantis, G Rattan, R Giannace, S Campagna, C Gennari. Most Helicobacter pylori-infected patients have specific antibodies, and some also have H-pylori antigens and genomic material in the bile: Is it a risk factor for gallstone formation? Digestive Diseases and Sciences 43: 4 (APR 1998):854-862.

3) G Falck, I Engstrand, A Gad, J Gnarpe, H Gnarpe, A Laurila. Demonstration of Chlamydia pneumoniae in patients with chronic pharyngitis. Scandinavian Journal of Infectious Diseases 29: 6(1997):585-589.

4) K Numazaki, S Chiba, K Aoki, K Suzuki, S Ohno. Detection of serum antibodies to Chlamydia pneumoniae in patients with endogenous uveitis and acute conjunctivitis. Clinical Infectious Diseases 25: 4 (OCT 1997):928-929.

5) JSH Gaston, KHO Deane, RM Jecock, JH Pearce. Identification of 2 Chlamydia trachomatis antigens recognized by synovial fluid T cells from patients with Chlamydia induced reactive arthritis. Journal of Rheumatology 23: 1 (JAN 1996):130-136.

6) IA Tait, SJ Duthie, D Taylorrobinson. Silent upper genital tract chlamydial infection and disease in women. International Journal of STD & AIDS 8: 5 (MAY 1997):329-331.

7) A Yuce, M Yucesoy, K Yucesoy, T Canda, M Fadiloglu, A Gure, N Yulug. Ureaplasma urealyticum induced urinary tract stones in rats. Urological Research 24: 6 (DEC 1996):345-348.

8) JAMA. 1997(Dec 17);278(23):2051-2.

9) S Halme, H Syrjala, A Bloigu, P Saikku, M Leinonen, J Airaksinen, HM Surcel. Lymphocyte responses to Chlamydia antigens in patients with coronary heart disease. European Heart Journal 18: 7 (JUL 1997):1095-1101.

10) Jackson, LA Campbell, CC Kuo, DI Rodriguez, A Lee, JT Grayston. Isolation of Chlamydia pneumoniae from a carotid endarterectomy specimen. Journal of Infectious Diseases 176: 1 (JUL 1997):292-295.

11) Grether JK, Nelson KB. Maternal infection and cerebral palsy in infants of normal birth weight. JAMA 1997(July 16);278:207-211.

12) N Kjaergaard, D Hansen, ES Hansen, HC Schoenheyder, N Uldbjerg, H Madsen. Pyospermia and preterm, prelabor, rupture of membranes. Acta Obstetricia et Gynecologica Scandinavica 76: 6(JUL 1997):528-531.

13) PJ Cook, GYH Lip, P Davies, DG Beevers, R Wise, D Honeybourne. Chlamydia pneumoniae antibodies in severe essential hypertension. Hypertension 31: 2 (FEB 1998):589-594.

14) PA Gurr, A Chakraverty, V Callanan, SJ Gurr. The detection of Mycoplasma pneumoniae in nasal polyps. Clinical Otolaryngology 21: 3 (JUN 1996):269-273.

15) 9% of newborns get a stuffy nose taht is casued by mycoplasma and cannot be cultured by routine laboratory methods. NM Iskandar, MB Naguib. Chlamydia trachomatis: An underestimated cause for rhinitis in neonates. International Journal of Pediatric Otorhinolaryngology. 42: 3 (JAN 1998):233-237.

16) S Wessely. Chronic fatigue syndrome. Journal of the Royal College of Physicians of London. 30: 6 (NOV-DEC 1996):497-504.

17) L Cirasino, A Marccotti, C Barosi, F Massaro, A Silvani. Misdiagnosis of post-traumatic splenic rupture in a patient with acute cold agglutinin disease due to Mycoplasma infection. Scandinavian Journal of Infectious Diseases 29: 5(1997):522-524.

18) Y Aihara, M Mori, T Kobayashi, S Yokota. A pediatric case of polymyositis associated with Mycoplasma pneumoniae infection. Scandinavian Journal of Rheumatology 26: 6 (1997):480-481.

19) Braun et al. Chlamydia pneumoniae- a new causitive agent of reactive arthritis and undifferentiated arthritis. Ann Rheum Dis 1994;53:100-105. 20) Gerard HC et al. Screening of synovial tissue from reactive arthritis patients for the presence of chlamydia pneumoniae. Arthritis Rheum 1995;38:S394.

19a) TM Korman, JD Turnidge, ML Grayson. Neurological complications of chlamydial infections: Case report and review. Clinical Infectious Diseases 25: 4 (OCT 1997):847-851. cerebellar dysfunction, followed by respiratory failure requiring mechanical ventilation.

20) M Augenbraun, L Bachmann, T Wallace, L Dubouchet, W Mccormack, EW Hook. Compliance with doxycycline therapy in sexually transmitted diseases clinics. Sexually Transmitted Diseases 25:1 (JAN 1998):1-4.

21) SD Hillis, FB Coles, B Litchfield, CM Black, B Mojica, K Schmitt, ME St Louis. Doxycycline and azithromycin for prvention of chlamydial persistence or recurrence one month after treatment in women - A se-effectiveness study in public health settings. Sexually Transmitted Diseases 25: 1 (JAN 1998):5-11.

22) TV Poggio, N Orlando, L Galanternik, S Grinstein. Microbiology of acute arthropathies among children in Argentina: Mycoplasma pneumoniae and hominis and Ureaplasma urealyticum. Pediatric Infectious Disease Journal 17: 4 (APR 1998):304-308.

23) J Haier, M Nasralla, AR Franco, GL Nicolson. Detection of mycoplasmal infections in blood of patients with rheumatoid arthritis.Rheumatology, 1999, Vol 38, Iss 6, pp 504-509.Nicolson GL, Inst Mol Med, 15162 Triton Lane, Huntington Beach,CA 92649 USA.

24) S Johnson, D Sidebottom, F Bruckner, D Collins. Identification of Mycoplasma fermentans in synovial fluid samples from arthritis patients with inflammatory disease. Journal of Clinical Microbiology, 2000, Vol 38, Iss 1, pp 90-93.

Checked  6/19/16

May 29th, 2014
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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