Ureaplasma urealyticum (Uu) is a bacterium without a cell wall, which makes it difficult to culture. Uu colonizes the lower genitourinary tract and is transmitted through sexual contact. The presence of Uu is higher in persons with immunosuppressive disease or treatment. Moreover, these persons are at increased risk of developing invasive Uu infections. We present a case concerning a 47-year-old female with multiple sclerosis treated with Rituximab. She first presented with a urinary tract infection and bartholinitis. Despite treatment with antibiotics and surgical procedures, the infection disseminated and led to intra-abdominal abscesses and empyema. Repeated cultures were negative, which prolonged the time to diagnosis and accurate treatment. Uu was detected with 16S rRNA PCR assays during the course of the disease but was interpreted as non-pathogenic Finally, Uu was suspected as the causing agent, treatment with doxycycline was initiated, and the patient recovered after nine months of disease.
Ureaplasma urealyticum förekommer urogenitalt hos män och kvinnor efter sexualdebut, och bärarskap ses hos 33 procent av kvinnor som söker STI-mottagning.
Patienter med nedsatt immunförsvar på grund av sjukdom eller läkemedelsbehandling kan drabbas av invasiv Ureaplasmainfektion; vanligast är septisk artrit.
Ureaplasma urealyticum detekteras enklast med PCR-analys för 16S rRNA, då bakterien saknar cellvägg och inte växer i vanliga odlingsmedier.
Ureaplasma urealyticum behandlas företrädesvis med tetracykliner (doxycyklin).
Samarbete mellan olika specialiteter är viktigt för diagnos och behandling.