Skip to main content

Mycoplasmal Arthritis

  • Chapter
  • First Online:
Infections and the Rheumatic Diseases
  • 755 Accesses

Abstract

Mycoplasmas are free-living microorganisms that belong to the Mollicutes class (cell wall–free bacteria), ubiquitous, and primarily commensals residing on mucosal surfaces as part of microbiomes of healthy people, but sometimes they may produce diseases in the respiratory, genitourinary, and musculoskeletal systems. These microorganisms may be pathogenic agents in immunocompetent and immunosuppressed individuals. Septic arthritis and reactive arthritis associated with these microorganisms have been described. The clinical manifestations are acute, and the articular pattern can be monoarthritis or polyarthritis. Diagnosis is made with the use of laboratory tests such as serology, culture in special medium, and molecular technology (PCR). Macrolides and related antibiotics are therapies of first choice.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Holzman RS, Simberkoff MS. Mycoplasma diseases. In: Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 8th ed: Elsevier Saunders; 2015.

    Google Scholar 

  2. Waites KB, Taylor-Robinson D. Mycoplasma and ureaplasma. In: Versalovic J, Carroll KC, Funke G, et al., editors. Manual of clinical microbiology, vol. 1. 10th ed: ASM Press; 2011.

    Google Scholar 

  3. Cassel GH, Cole BC. Mycoplasma as agents of human disease. N Engl J Med. 1981;8:80–9.

    Article  Google Scholar 

  4. Taylor-Robinson D. Infections due to species of Mycoplasma and Ureaplasma: an update. Clin Infect Dis. 1996;23:671–84.

    Article  CAS  Google Scholar 

  5. Daley GM, Russell DB, Tabrizi SN, McBride J. Mycoplasma genitalium: a review. Int J STD AIDS. 2014;25:475–87.

    Article  CAS  Google Scholar 

  6. Hayes MM, Li BJ, Wear DJ, Lo SC. Pathogenicity of Mycoplasma fermentans and Mycoplasma penetrans in experimentally infected chicken embryos. Infect Immun. 1996;64:3419–24.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Kokkayil P, Dhawan B. Ureaplasma: current perspectives. Indian J Med Microbiol. 2015;33:205–14.

    Article  CAS  Google Scholar 

  8. Waites KB, Katz B, Schelonka RL. Mycoplasmas and ureaplasmas as neonatal pathogens. Clin Microbiol Rev. 2005;18:757–89.

    Article  Google Scholar 

  9. Wu JR, Wang B, Zhou LJ, Xie YX, Xu JS, Chen LS, Yang T, Guo HX. Mycoplasmas infection in male HIV/AIDS patients in Jiangsu, China. Microb Pathog. 2013;63:54–8.

    Article  Google Scholar 

  10. Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004;17:697–728.

    Article  CAS  Google Scholar 

  11. Narita M. Pathogenesis of extrapulmonary manifestations of Mycoplasma pneumoniae infection with special reference to pneumonia. J Infect Chemother. 2010;16:162–9.

    Article  Google Scholar 

  12. Lambert HP. Syndrome with joint manifestations in association with mycoplasma pneumonia. Br Med J. 1968;3:156–7.

    Article  CAS  Google Scholar 

  13. Hernadez LA, Urquhart GED, Dick CLW. Mycoplasma pneumonia infection and arthritis in man. Br Med J. 1977;2:14–6.

    Article  Google Scholar 

  14. Ponka A. Arthritis associated with mycoplasma pneumoniae infection. Scand J Rheumatol. 1979;8:27–32.

    Article  CAS  Google Scholar 

  15. Davis CP, Cochran S, Lisse J, Buck G, DiNuzzo AR, Weber T, Reinarz JA. Isolation of Mycoplasma pneumoniae from synovial fluid samples in a patient with pneumonia and polyarthritis. Arch Intern Med. 1988;148:969–70.

    Article  CAS  Google Scholar 

  16. Leli C, Mencacci A, Latino MA, Clerici P, Rassu M, Perito S, et al. Prevalence of cervical colonization by Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis and Mycoplasma genitalium in childbearing age women by a commercially available multiplex real-time PCR: an Italian observational multicentre study. J Microbiol Immunol Infect. 2018;51:220–5.

    Article  Google Scholar 

  17. Bojović J, Strelić N, Pavlica L. Reiter's syndrome--disease of young men-- analysis of 312 patients. Med Pregl. 2014;67:222–30.

    Article  Google Scholar 

  18. Chrisment D, Machelart I, Wirth G, Lazaro E, Greib C, Pellegrin JL, Bébéar C, Peuchant O. Reactive arthritis associated with Mycoplasma genitalium urethritis. Diagn Microbiol Infect Dis. 2013;77:278–9.

    Article  CAS  Google Scholar 

  19. Furr PM, Taylor-Robinson D, Webster AD. Mycoplasmas and ureaplasmas in patients with hypogammaglobulinaemia and their role in arthritis: microbiological observations over twenty years. Ann Rheum Dis. 1994;53:183–7.

    Article  CAS  Google Scholar 

  20. Lehmer RR, Andrews BS, Robertson JA, Stanbridge EJ, de la Maza L, Friou GJ. Clinical and biological characteristics of Ureaplasma urealyticum induced polyarthritis in a patient with common variable hypogammaglobulinaemia. Ann Rheum Dis. 1991;50:574–6.

    Article  CAS  Google Scholar 

  21. George MD, Cardenas AM, Birnbaum BK, Gluckman SJ. Ureaplasma septic arthritis in an immunosuppressed patient with juvenile idiopathic arthritis. J Clin Rheumatol. 2015;21:221–4.

    Article  Google Scholar 

  22. Goulenok TM, Bialek S, Gaudart S, Bébéar C, Fantin B. Ureaplasma urealyticum destructive septic arthritis in a patient with systemic lupus erythematosus after rituximab therapy. Joint Bone Spine. 2011;78:323–4.

    Article  Google Scholar 

  23. Farrell JJ, Larson JA, Akeson JW, Lowery KS, Rounds MA, Sampath R, et al. Ureaplasma parvum prosthetic joint infection detected by PCR. J Clin Microbiol. 2014;52:2248–50.

    Article  Google Scholar 

  24. Ramirez AS, Rosas A, Hernández-Berian JA, et al. Relationship between rheumatoid arthritis and Mycoplasma pneumoniae: a case-control study. Rheumatology (Oxford). 2005;44:912–4.

    Article  CAS  Google Scholar 

  25. McEvoy T. Minocycline: rheumatoid arthritis. Hosp Pharm. 2016;51:535–8.

    Article  CAS  Google Scholar 

  26. O'Dell JR. Is there a role for antibiotics in the treatment of patients with rheumatoid arthritis? Drugs. 1999;57:279–82.

    Article  CAS  Google Scholar 

  27. Schaeverbeke T, Gilroy CB, Bébéar C, Dehais J, Taylor-Robinson D. Mycoplasma fermentans, but not M penetrans, detected by PCR assays in synovium from patients with rheumatoid arthritis and other rheumatic disorders. J Clin Pathol. 1996;49:824–8.

    Article  CAS  Google Scholar 

  28. Horowitz S, Evinson B, Borer A, Horowitz J. Mycoplasma fermentans in rheumatoid arthritis and other inflammatory arthritides. J Rheumatol. 2000;27:2747–53.

    CAS  PubMed  Google Scholar 

  29. Gilroy CB, Keat A, Taylor-Robinson D. The prevalence of Mycoplasma fermentans in patients with inflammatory arthritides. Rheumatology (Oxford). 2001;40:1355–8.

    Article  CAS  Google Scholar 

  30. Kawahito Y, Ichinose S, Sano H, Tsubouchi Y, Kohno M, Yoshikawa T, Tokunaga D, Hojo T, Harasawa R, Nakano T, Matsuda K. Mycoplasma fermentans glycolipid-antigen as a pathogen of rheumatoid arthritis. Biochem Biophys Res Commun. 2008;369:561–6.

    Article  CAS  Google Scholar 

  31. Johnson SM. The importance of B-cells and ecto-5'nucleotidase in Mycoplasma fermentans infection and the relevance to rheumatoid arthritis. Immunology. 2008;123:187–96.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Rivera A, Yáñez A, León-Tello G, Gil C, Giono S, Barba E, Cedillo L. Experimental arthritis induced by a clinical Mycoplasma fermentans isolate. BMC Musculoskelet Disord. 2002;3:15–21.

    Article  Google Scholar 

  33. Meseguer-Peinado MA, Acosta-Bogab B, Matas-Andreuc L, Codina-Graud G. Diagnóstico microbiológico de las infecciones por Mycoplasma. Enfermedades Infecciosas y Microbiologia Clínica. 2012;30(8):500–4.

    Article  Google Scholar 

  34. Waites KB, Xiao L, Paralanov V, Viscardi RM, Glass JI. Molecular methods for the detection of mycoplasma and ureaplasma infections in humans. J Mol Diagn. 2012;14:437–50.

    Article  CAS  Google Scholar 

  35. Beersma MF, Dirven K, van Dam AP, Templeton KE, Claas EC, Goossens H. Evaluation of 12 commercial tests and the complement fixation test for Mycoplasma pneumoniae-specific immunoglobulin G (IgG) and IgM antibodies, with PCR used as the “gold standard”. J Clin Microbiol. 2005;43:2277–85.

    Article  CAS  Google Scholar 

  36. Chen D, Zhang Y, Xu Y, Shen T, Cheng G, Huang B, et al. Comparison of chemiluminescence immunoassay, enzyme-linked immunosorbent assay and passive agglutination for diagnosis of Mycoplasma pneumoniae infection. Ther Clin Risk Manag. 2018;14:1091–7.

    Article  CAS  Google Scholar 

  37. Daxboeck F, Krause R, Wenisch C. Laboratory diagnosis of Mycoplasma pneumoniae infection. Clin Microbiol Infect. 2003;9:263–73.

    Article  CAS  Google Scholar 

  38. Loens K, Ursi D, Goossens H, Ieven M. Molecular diagnosis of Mycoplasma pneumoniae respiratory tract infections. J Clin Microbiol. 2003;41:4915–23.

    Article  CAS  Google Scholar 

  39. Daxboeck F, Khanakah G, Bauer C, Stadler M, Hofmann H, Stanek G. Detection of Mycoplasma pneumoniae in serum specimens from patients with mycoplasma pneumonia by PCR. Int J Med Microbiol. 2005;295:279–85.

    Article  CAS  Google Scholar 

  40. Loens K, Goossens H, Ieven M. Acute respiratory infection due to Mycoplasma pneumoniae: current status of diagnostic methods. Eur J Clin Microbiol Infect Dis. 2010;29:1055–69.

    Article  CAS  Google Scholar 

  41. Michelow IC, Olsen K, Lozano J, Duffy LB, McCracken GH, Hardy RD. Diagnostic utility and clinical significance of naso- and oropharyngeal samples used in a PCR assay to diagnose Mycoplasma pneumoniae infection in children with community-acquired pneumonia. J Clin Microbiol. 2004;42:3339–41.

    Article  CAS  Google Scholar 

  42. Xiao L, Glass JI, Paralanov V, Yooseph S, Cassell GH, Duffy LB, Waites KB. Detection and characterization of human Ureaplasma species and serovars by real-time PCR. J Clin Microbiol. 2010;48:2715–23.

    Article  CAS  Google Scholar 

  43. Grau O, Kovacic R, Griffais R, Launay V, Montagnier L. Development of PCR-based assays for the detection of two human mollicute species: Mycoplasma penetrans and M hominis. Mol Cell Probes. 1994;8:139–47.

    Article  CAS  Google Scholar 

  44. Yoshida T, Maeda S, Deguchi T, Miyazawa T, Ishiko H. Rapid detection of Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum organisms in genitourinary samples by PCR-microtiter plate hybridization assay. J Clin Microbiol. 2003;41:1850–5.

    Article  CAS  Google Scholar 

  45. Kong F, Ma Z, James G, Gordon S, Gilbert GL. Species identification and subtyping of Ureaplasma parvum and Ureaplasma urealyticum using PCR-based assays. J Clin Microbiol. 2000;38:1175–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  46. Povlsen K, Jensen JS, Lind I. Detection of Ureaplasma urealyticum by PCR and biovar determination by liquid hybridization. J Clin Microbiol. 1998;36:3211–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  47. Lee AH, Ramanujam T, Ware P, Edelstein PH, Brooks JJ, Freundlich B, Schumacher HR Jr, et al. Molecular diagnosis of Ureaplasma urealyticum septic arthritis in a patient with hypogammaglobulinemia. Arthritis Rheum. 1992;35:443–8.

    Article  CAS  Google Scholar 

  48. Winchell JM, Thurman KA, Mitchell SL, Thacker WL, Fields BS. Evaluation of three real-time PCR assays for detection of Mycoplasma pneumoniae in an outbreak investigation. J Clin Microbiol. 2008;46:3116–8.

    Article  CAS  Google Scholar 

  49. Dumke R, Schurwanz N, Lenz M, Schuppler M, Luck C, Jacobs E. Sensitive detection of Mycoplasma pneumoniae in human respiratory tract samples by optimized real-time PCR approach. J Clin Microbiol. 2007;45:2726–30.

    Article  CAS  Google Scholar 

  50. Taylor-Robinson D, Bébéar C. Antibiotic susceptibilities of mycoplasmas and treatment of mycoplasmal infections. J Antimicrob Chemother. 1997;40:622–3.

    Article  CAS  Google Scholar 

  51. Pereyre S, Goret J, Bébéar C. Mycoplasma pneumoniae: current knowledge on Macrolide resistance and treatment. Front Microbial. 2016;7:974–84.

    Google Scholar 

  52. Cao B, Qu JX, Yin YD, Eldere JV. Overview of antimicrobial options for Mycoplasma pneumoniae pneumonia: focus on macrolide resistance. Clin Respir J. 2017;11:419–29.

    Article  CAS  Google Scholar 

  53. Wang QY, Li RH, Zheng LQ, Shang XH. Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in female outpatients, 2009-2013. J Microbiol Immunol Infect. 2016;49:359–62.

    Article  CAS  Google Scholar 

  54. Foschi C, Salvo M, Galli S, Moroni A, Cevenini R, Marangoni A. Prevalence and antimicrobial resistance of genital Mollicutes in Italy over a two-year period. New Microbiol. 2018;41:153–8.

    CAS  PubMed  Google Scholar 

  55. Soni S, Horner P, Rayment M, Pinto-Sander N, Naous N, Parkhouse A, et al. 2018 BASHH UK national guideline for the management of infection with Mycoplasma genitalium. Available from: https://www.bashhguidelines.org/current-guidelines/urethritis-and-cervicitis/mycoplasma-genitalium-2018/.

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Vega, L.E., Espinoza, L.R. (2019). Mycoplasmal Arthritis. In: Espinoza, L. (eds) Infections and the Rheumatic Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-23311-2_27

Download citation

Publish with us

Policies and ethics