Mycoplasma hominis Septic Arthritis: Two Case Reports and Review

Abstract

Mycoplasma hominis is normally a commensal of humans. When the organism is pathogenic, it primarily causes disease in the genitourinary tract. Septic arthritis caused by M. hominis is a rare condition that occurs chiefly in the postpartum period, in immunosuppressed hosts, or in patients who have recently undergone urinary tract manipulation. Arthritis caused by M. hominis is clinically indistinguishable from septic arthritis caused by other bacteria. Diagnosis is often delayed because infection with this organism is not suspected or because it grows slowly, if at all, in routine culture media. Appropriate therapy often leads to a good outcome, although relapses and resistance have been reported.

Hypogammaglobulinemic Patient with Polyarthritis Mimicking Rheumatoid Arthritis Finally Diagnosed as Septic Arthritis Caused by Mycoplasma hominis

“…Many antibiotics were used in this case, including a quinolone (pazufloxacin) but not tetracycline. M. hominis has also been reported to be moderately susceptible to rifampicin (14), and the pleuritis in this case was somewhat improved by antituberculosis therapy. Since the diagnosis of mycoplasma infections is difficult and slow (15), tetracycline treatment should be administered to patients with hypogammaglobulinemia showing arthritis, pleuritis, meningitis, or any other diseases that may be caused by mycobacterium infection.…”

“…Septic arthritis due to M. hominis has been reported previously, and most patients were receiving immunosuppressive therapy for SLE, post-organ transplantation, leukemia, or underlying immunosuppressive disease such as hypogammaglobulinemia or diabetes mellitus (14)(15)(16)(17)(18)(19)(20). Arthroplasty and ligament repair were also underlying conditions (14,15).…”

“…However, streptomycin, clindamycin, and quinolones are also used in cases in which tetracyclines are not sufficiently effective (14,24). Many antibiotics were used in this case, including a quinolone (pazufloxacin) but not tetracycline.…”

“…Arthroplasty and ligament repair were also underlying conditions (14,15). Previous reports of septic arthritis due to M. hominis showed that monoarthritis or oligoarthritis of large joints such as the knee, shoulder and/or hip first occur (14)(15)(16)(17)(18)(19)(20) and then polyarthritis develops in the small joints (16,18). In the case presented here, two months had passed before admission to hospital and polyarthritis in six large (bilateral hips, knees, shoulders) and one small (the PIP joint of the right middle finger) joints had developed.…”

A case of Mycoplasma hominis septic arthritis postpartum

“…Predisposing risk factors include underlying joint abnormality, recent genitourinary surgery or manipulation and immunocompromised states following solid organ transplant, hypogammaglobulinaemia, collagen vascular disorders and haematological malignancies. 3,4,6 We report a case of septic arthritis caused by M. hominis, occurring in the postpartum period in an otherwise healthy woman.…”