Mycoplasma and mycoplasmosis
- Etiology and pathogenesis of the pathogen of mycoplasmosis
- Characteristic features of mycoplasma
- The causes of mycoplasmosis
- Symptoms of mycoplasmosis
- Diagnosis of mycoplasmosis
- Treatment of mycoplasmosis
- Consequences of mycoplasmosis
- Prophylaxis of mycoplasmosis
Mycoplasmosis is a term that combines a group of infections caused by mycoplasma (non-nuclear microorganisms), affecting the genitourinary and respiratory system, the musculoskeletal system and the organs of vision. There are about seventy kinds of mycoplasmas known to science, but only a few are dangerous for human health.
Mycoplasma was first isolated in 1898 in France from the organism of cows suffering from pneumonia. A little later, in 1928, scientists drew attention to a strange "virus" in bulls, and in 1937 Edzall and Dienes found out that mycoplasma also inhabits the human body. They singled it out during the study of abscesses of the Bartholin glands. In the body of healthy women (in the area of the cervical canal), the causative agent was detected in 1942, and at the same time mycoplasma was found in the urethra of men. And a few years later it was proved that mycoplasmosis is a venereal disease that can provoke quite serious consequences.
Etiology and pathogenesis of the pathogen of mycoplasmosis
Mycoplasma is a gram-negative unicellular microorganism, which is a representative of the class of molluscutes. It occupies an intermediate position between fungi, viruses and bacteria. The cell membrane of mycoplasma lacks a rigid cell membrane (this is the difference between prokaryotes and bacteria, in which the cells are covered with a carbohydrate-protein capsule). In this case, the environment of the cell is protected by plasmalemma (the thinnest film visible only in the electron microscope). It consists of a complex of lipoproteins, into which molecules of proteins and lipids enter. With the help of the plasmolemma, the parasite attaches itself to the cells of the host organism, and then lives and develops at the expense of its intracellular resources. At the same time, it becomes difficult for immune mechanisms.
The size of the mycoplasma ranges from 0.2 to 0.8 μm, and therefore the pathogen is able to freely penetrate through all the protective filters created by the body. This microorganism parasitizes on the surface of the mucous membranes. This is perhaps the smallest microbe, capable of independent replication, like a tiny jellyfish. Its flexible membrane is capable of taking various forms, and therefore, even with a super-power electron microscope, mycoplasma is very difficult to detect. In chronic mycoplasmosis, the agent under magnification looks like a fried egg, but at the same time, it very often can take filiform or pear-shaped forms.
Upon contact with the mucous membranes, the pathogen, adhering to the cellular epithelium, provokes the development of local inflammatory reactions without manifesting cytogenous effects. Mycoplasma interacts with the cellular apparatus, which leads to a change in its cytogenic structure and provokes the development of autoimmune processes.
Characteristic features of mycoplasma
- In the process of its life, mycoplasma recycles some substrates containing steroidal alcohols (in particular, cholesterol), which are necessary for its further growth and development.
- The parasite is able to grow and multiply in the cell-free space.
- Unlike viruses, it has sensitivity to a number of antibiotics.
- DNA and RNA are present simultaneously in the mycoplasma cell.
- There is a tendency towards specificity with respect to the host.
- The parasite is capable of being both an immunostimulant and an immunosuppressor.
- Mycoplasma can cause respiratory pathologies and diseases of the urogenital tract.
The causes of mycoplasmosis
In the human body, 11 species of mycoplasmas parasitize, but only Mycoplasma genitalium, Mycoplasma pneumonia and Mycoplasma hominis can provoke the disease. To this day, there are discussions among scientists on the pathogenicity of these microorganisms, and so far there is no single answer, under what circumstances mycoplasma becomes the cause of the disease.
In the opinion of many authors, the microorganism itself is not dangerous in itself, since it can be not only a parasite, but also a saprophyte and is often found in perfectly healthy people.
The main causes of the disease include:
- Oral, genital or anal intercourse;
- The vertical route of transmission of infection from an infected mother to the fetus through the placenta;
- Passage through infected birth canal.
Symptoms of mycoplasmosis
Mycoplasma genitalium mycoplasmosis
Mycoplasma genitalia is a fairly dangerous infectious agent that can be detected in both women and men. With the development of the pathological process in the patient with urination appears burning, and sometimes painful. This condition is explained by the fact that when the urethra is affected, adjacent tissues become inflamed, and as a consequence, their sensitivity is aggravated.
In women infected with mycoplasma, the genitalia during sexual contact, because the walls of the urethra are in close proximity to the walls of the vagina, there is a sharp pain. Often, the acute form of the disease is preceded by the incubation period, and only 7-10 days after infection, the first signs of urogenital mycoplasmosis may appear (less often - not earlier than a month).
Mycoplasmosis of the respiratory system
When detected in smears from the throat and in the blood of the patient Mycoplasma pneumonia causative agent, there is a suspicion of infection with mycoplasma, causing pneumonia. This is a kind of bacteria that can provoke the development of diseases of the respiratory system (respiratory mycoplasmosis), proceeding according to the type of pneumonia, tracheitis, bronchitis and pharyngitis. In clinical practice, atypical (mycoplasmal) pneumonia accounts for 20% of the total number of diseases. In this case, the source of infection is a sick person or a carrier. On the average, with respiratory mycoplasmosis, the incubation period lasts one to two weeks. The disease develops gradually. The patient suffers from a dry, debilitating cough, sometimes accompanied by a discharge of scant sputum. Most often, the temperature is normal or subfebrile, but sometimes it can cross the level of 38 degrees. As a rule, patients complain of cough, sore throat and nasal congestion, as well as hyperemia of the mucous membrane of the pharynx and oral cavity. If the bronchial branches are involved in the inflammatory process, dry rales develop and dry breathing occurs.
In severe cases, respiratory mycoplasmosis can give complications to the heart and the nervous system. Fortunately, lethal cases in this case are now very rare.
Urogenital mycoplasmosis, provoked by Mycoplasma hominis
Mycoplasma hominis is a saprophytic microorganism that lives in the urinary tract of every person. However, under certain conditions, it can provoke the development of serious pathologies. Most often, when an inflammation occurs, patients complain of painful urination. In some cases, the symptoms of urogenital mycoplasmosis are confused with symptoms of gonorrhea or trichomoniasis. Within a few weeks after infection, women have vaginal discharge with a very unpleasant odor, and during sexual intercourse many patients due to inflammation of the ureter experience discomfort and even pain.
Diagnosis of mycoplasmosis
Diagnosis of the disease occurs in several stages. First of all, the patient undergoes a thorough examination with a specialist. Next, a laboratory diagnosis is carried out, which involves the use of various techniques.
During visual inspection, the condition of the mucous membrane of the vaginal walls and cervix of the uterus is determined. In the case when a visual examination reveals abundant secretions with a characteristic pungent odor, as well as inflammation of the cervical canal and the vaginal mucosa, a good specialist immediately suspects the development of urogenital mycoplasmosis.
In the presence of characteristic symptoms, the patient is recommended to have an ultrasound of the pelvic organs, as well as additional laboratory tests.
To determine the causes of the inflammatory process, the patient takes a cytological or bacteriological smear.
: данный анализ необходим для выявления других заболеваний, передающихся половым путем, и имеющим схожую с микоплазмозом симптоматику, однако с его помощью выявить микоплазму не возможно. Note : this analysis is necessary for the detection of other sexually transmitted diseases and having a symptomatic similar to mycoplasmosis, however, it is not possible to detect mycoplasma with its help.
To make an accurate diagnosis, a bacteriological culture of the secretions is carried out. With the help of this analysis, it is possible not only to identify the causative agent of mycoplasmosis, but also to establish its sensitivity to antibacterial drugs.
It should be noted that to date, this technique is considered not sufficiently effective, and therefore in the course of diagnosis, patients are required to prescribe PCR analysis for mycoplasmosis. With its help, 90% of patients are diagnosed with a pathogen.
Polymerase chain reaction is a rather sensitive technique that involves the determination of the DNA of a microorganism.
When setting the immunological assay for mycoplasmosis, antibodies IgG and IgM are determined. Despite the fact that such a technique is often used in the diagnosis, it is considered not sufficiently informative, and therefore many authors recommend that it be conducted only to assess the effectiveness of treatment.
Treatment of mycoplasmosis
In the event that during the diagnosis the test for the presence of the pathogen of mycoplasma gave a positive result, it is not an absolute indication for the purpose of treatment. At the expressed symptomatology of one of the urological or gynecological pathologies, the cause of which may be mycoplasma, a bacterioscopic examination of the smear for the presence of other types of pathogenic microorganisms is mandatory. It should be noted that the causative agent of mycoplasmosis itself rarely causes an inflammatory process in the urogenital tract. Therefore, a further therapeutic strategy will depend on the type of concomitant infections.
Treatment of mycoplasmosis is a rather complicated process. As a rule, it is held in a complex.
The greatest effect, of course, in this case has antibacterial therapy. However, not all antibiotics can destroy the causative agent of mycoplasmosis. The selective effect of antibacterial drugs is associated with the characteristics of the infection. The fact is that mycoplasma lacks the cell membrane, whereas most of the broad-spectrum antibiotics act on its protein elements. Therefore, the treatment of this pathology should be trusted by a true professional.
Unfortunately, the human body is not able to develop immunity to this infection, and therefore it will be necessary to treat both sex partners simultaneously. In this case, a sufficiently high probability of relapse should be taken into account. Therefore, to prevent re-infection and improve the effectiveness of treatment, many specialists use innovative technologies of extracorporeal antibiotic therapy. This technique involves the incubation of high doses of antibiotics and the simultaneous conduct of plasma (the purification of blood).
In addition, antifungal and antiprotozoal drugs, active against the simplest unicellular organisms, are prescribed additionally with antibacterial treatment, and immunotherapy, instillation with liquid medications of the urethra and physiotherapeutic treatment are prescribed.
Consequences of mycoplasmosis
1. Mycoplasmosis is an infectious disease that causes many gynecological problems. This pathology can provoke the development of endometritis, salpingitis, as well as other inflammatory processes in the vagina and cervical canal.
In the case when it is not possible to find out the cause of the disease for a long time, it is likely that it is caused by mycoplasma infection.
With the development of a latent form of mycoplasmosis, primary miscarriage of the fetus, placental abnormalities, polyhydramnios and other complications arising during pregnancy can be observed in patients. In the chronic form of the pathological process, often due to the violation of ovulation, develops secondary infertility.
Very often, women who have undergone mycoplasmosis are diagnosed with various inflammatory processes of the pelvic organs. In the case where the pathogen is transmitted vertically, that is, from mother to fetus, it can in the first trimester of pregnancy provoke spontaneous abortion, and in the latter - cause premature birth.
2. In children, mycoplasma can cause diseases of the respiratory system, as well as pathology of the urogenital tract. In this case, the causative agent of the infection is detected on the mucous membranes of the upper respiratory tract and on the lungs. In girls, they can affect the vulva and vagina, and boys have a bladder.
With the development of respiratory mycoplasmosis, a child suffers from a dry cough of a paroxysmal nature, which most often develops at night and often resembles a cough with whooping cough. This condition can persist for several weeks and even months. Then the cough is gradually moistened, and rumbling rales appear in the lungs. In some cases, with the development of mycoplasmosis in children, a small rapid rash appears on the body.
The incubation period with the development of mycoplasmal pneumonia lasts from two weeks to one and a half months. This pathology is characterized by an acute onset. The child refuses to eat, there are complaints about headaches, lethargy is noted, and also repeated vomiting may appear. Atypical pneumonia, caused by the pathogen of mycoplasmosis, flows undulating, with little oxygen deficiency.
In the case when bronchial tubes are involved in the inflammatory process, the disease also has a protracted course. Moreover, against the background of disorders occurring in the respiratory system, the child often develops an out-respiratory changes. These include pain in the joints (arthralgia), affecting one or two of the largest articular joints, a small-point rash or large red spots of irregular shape appear on the body, and some groups of lymph nodes increase.
However, mycoplasmosis in children can manifest with uncharacteristic signs for it. Sometimes the child has an increased flatulence, increases the liver and spleen, as well as symptoms of damage to the nervous system.
In newborns whose blood reveals mycoplasma, from the very first days of life, pneumonia, meningitis or severe kidney damage can develop. Unfortunately, to this day there is no inoculation against mycoplasmosis, and therefore only timely adequate treatment can save the child from a lethal outcome.
3. In men, mycoplasmosis is very rarely diagnosed. However, they can be carriers of infection. Therefore, in the absence of symptoms in the blood of the subject, antibodies to the causative agent of the disease are often found.
In 40% of cases of mycoplasmosis in men, the disease is hidden. However, under stress or immunosuppression, the pathogen is activated and leads to the development of a number of complications. In such cases, patients complain of the emergence in the morning of uninvolved translucent secretions, a burning sensation when urinating, discomfort and drawing pains in the groin.
In the case when mycoplasma affects the testicles, hyperemia, tenderness in the scrotal area, as well as an increase in testes in size is observed. Such a condition often becomes a cause of a violation of the process of spermatogenesis.
Prophylaxis of mycoplasmosis
In the prevention of mycoplasmosis, the main role, according to experts, is played by early diagnosis of sexually transmitted diseases and other non-venereal genitourinary infections.
For the purposes of prevention, couples who marry and want to give birth to a child and pregnant women should be examined for mycoplasmosis.
At casual sexual contacts, in order to avoid infection, it is strongly recommended to use condoms, and, if possible, to treat the external genitalia with a special antiseptic in the first two hours after sexual intercourse.
Another important means of preventing mycoplasmosis is the timely detection and treatment of the disease not only in patients, but also in their sexual partners.
Do not forget that in most men and women mycoplasmal infection, passing into a chronic course, proceeds in a latent form, without manifesting itself and without causing any subjective sensations. That is why most people, considering themselves healthy, are not examined in time, and are potential spreaders of the infection.
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