Mycoplasma vaginalis

The human body can be infected in many parts, and the transmission routes also include many types, mainly in the vagina or urethra, as well as the uterine cavity and drug liquid. This is a kind of sexually transmitted disease. After infection, it may even be transmitted to pregnant women. The harm is very serious. When mycoplasma infection leads to vaginitis, treatment requires diagnosis first and then treatment.

Diagnosis and treatment of mycoplasma vaginitis

1. Pathogens

The pathogens of mycoplasma infection include Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Mycoplasma genitalium (MG). Among them, ureaplasma urealyticum has the highest infection rate, which can not only cause inflammation of the urinary tract and reproductive tract, such as non-gonococcal urethritis, vaginitis, cervicitis, endometritis, and pelvic inflammatory disease, but in severe cases it can cause infection in pregnant women, infertility, and intrauterine growth retardation of the fetus, and the recurrence rate is high and treatment is difficult.

2. Mode of transmission

Mycoplasma exists in the vagina, around the urethral opening, external cervical opening and urine, and is mainly transmitted through sexual contact. When a pregnant woman is infected, the virus can be transmitted vertically through the placenta. During delivery, the fetus may also be infected through the contaminated birth canal.

3. Clinical manifestations

The infection site in women is often the cervix, which then invades the vagina and causes mycoplasma vaginitis. Mycoplasma vaginitis is often an inflammation of the reproductive system that spreads from the cervix. Most patients have no obvious subjective symptoms, and a few critically ill patients have a feeling of vaginal prolapse. When the infection spreads to the urethra, frequent urination and urgency are the main symptoms that attract the patient's attention.

When the infection is confined to the cervix, symptoms include increased leucorrhea, turbidity, cervical edema, congestion, or surface erosion. When the infection spreads to the urethra, symptoms include redness and congestion of the urethral opening. A small amount of secretions may overflow from the urethra when the urethra is squeezed, but tenderness rarely occurs. A common complication of mycoplasma infection is salpingitis, and a small number of patients may develop endometritis and pelvic inflammatory disease.

4. Diagnosis

Mycoplasma culture: Use a sterile cotton ball to clear the vaginal and cervical secretions, insert a sterile cotton swab 1 to 2 cm into the cervix, and gently rotate to remove the secretions containing columnar epithelial cells.

5. Treatment

Since mycoplasmas lack cell walls, β-lactam antibiotics that inhibit cell wall synthesis are ineffective against them. At the same time, mycoplasma infections are often slow to respond and take a long time to cure, so the correct choice of drugs is crucial to whether they can be cured.

Erythromycin and tetracycline were once considered the first choice antibiotics with proven efficacy, and the course of treatment was generally 7 to 10 days. However, with the widespread use of antibiotics, drug resistance has inevitably emerged. Generally speaking, the sensitivity rates of josamycin, doxycycline and minocycline to mycoplasma are all above 90%, and they are the main antibiotics for treating mycoplasma. If necessary, antibiotics can be selected based on the results of drug sensitivity tests.

6. Pregnancy complicated by mycoplasma infection

The preferred treatment is azithromycin 1 g orally, and the alternative treatment is erythromycin 0.5 g/bid orally for 14 days.

During treatment, sexual partners should be examined and treated at the same time. Mycoplasma test was repeated one month after treatment.