Chlamydial, mycoplasmal, and ureaplasmal mucosal infections

[Mary Mallozziberg]

Sexually transmitted urethritis, cervicitis, proctitis, and pharyngitis not due to gonorrhea are caused predominantly by chlamydiae and infrequently by mycoplasmas or Ureaplasma sp. Chlamydiae may also cause salpingitis, epididymitis, perihepatitis, neonatal conjunctivitis, and infant pneumonia. Untreated chlamydial salpingitis can become chronic, causing minimal symptoms but having serious consequences. Diagnosis is by culture, immunoassay for antigens, or nucleic acid–based tests. Treatment is with single-dose azithromycin or a week of ofloxacin , levofloxacin , erythromycin , or a tetracycline .
(See also Overview of Sexually Transmitted Diseases.)
Several organisms can cause nongonococcal sexually transmitted cervicitis in women and urethritis, proctitis, and pharyngitis in both sexes. These organisms include

Chlamydia trachomatis (responsible for about 50% of such cases of urethritis and most cases of mucopurulent cervicitis and may cause lymphogranuloma venereum)
Mycoplasma genitalium and M. hominis (which causes urogenital infections in women but not men)
Ureaplasma urealyticum
Trichomonas vaginalis (trichomoniasis)

The imprecise term quot;nonspecific urethritis” can be used, but only if tests for chlamydiae and gonococci are negative and no other pathogen is identified.
Chlamydiae and mycoplasmas also cause infections that are not sexually transmitted, including trachoma and neonatal conjunctivitis (chlamydiae) and pneumonia (chlamydiae and mycoplasmas).