Gremark Anna, Axelsson Ove
specialistläkare, obstetrik och gynekologi, Mälarsjukhuset, Eskilstuna.
seniorprofessor, överläkare, kvinnokliniken, Mälarsjukhuset, Eskilstuna; Centrum för klinisk forskning i Sörmland; institutionen för kvinnors och barns hälsa, Uppsala universitet.
Lakartidningen. 2022 Jul 5;119:22038.
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.
解脲脲原体（Uu）是一种无细胞壁的细菌，这使其难以培养。Uu定殖于下泌尿生殖道，并通过性接触传播。免疫抑制疾病患者或接受免疫抑制治疗者中Uu的检出率更高。此外，这些人发生侵袭性Uu感染的风险增加。我们报告一例47岁接受利妥昔单抗治疗的多发性硬化女性病例。她最初表现为尿路感染和巴氏腺炎。尽管使用了抗生素和手术治疗，但感染仍扩散并导致腹腔内脓肿和脓胸。多次培养均为阴性，这延长了诊断和准确治疗的时间。在病程中通过16S rRNA PCR检测到Uu，但被解释为非致病性。最终怀疑Uu为致病原，开始使用强力霉素治疗，患者在患病9个月后康复。
