Klein Elizabeth J, Almaghlouth Nouf K, Weigel Gabriela, Farmakiotis Dimitrios, Hardy Erica
Division of Infectious Diseases, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Department of Obstetrics and Gynecology, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Diagnostics (Basel). 2023 Nov 19;13(22):3478. doi: 10.3390/diagnostics13223478.
Genital mycoplasmas are sexually transmitted Mollicutes with a high prevalence of urogenital tract colonization among females of reproductive age. Current guidelines recommend against routine screening for these organisms, since their role in the pathogenesis of pelvic inflammatory disease and tubo-ovarian abscesses (TOAs) remains unclear. However, genital mycoplasmas harbor pathogenic potential in immunocompromised hosts, especially patients with hypogammaglobulinemia. It is important to identify such infections early, given their potential for invasive spread and the availability of easily accessible treatments. We present a young adult female with multiple sclerosis and iatrogenic hypogammaglobulinemia, with refractory, bilateral pelvic inflammatory disease and TOAs due to , identified as a single pathogen via three distinct molecular tests. To our knowledge, this is the second case of TOAs caused by in the literature, and the first diagnosed by pathogen cell-free DNA metagenomic next-generation sequencing in plasma.
生殖支原体是通过性传播的柔膜菌纲细菌，在育龄女性的泌尿生殖道定植率很高。目前的指南不建议对这些病原体进行常规筛查，因为它们在盆腔炎和输卵管卵巢脓肿（TOA）发病机制中的作用仍不明确。然而，生殖支原体在免疫功能低下的宿主中具有致病潜力，尤其是低丙种球蛋白血症患者。鉴于其有侵袭性传播的可能性以及有易于获得的治疗方法，早期识别此类感染很重要。我们报告了一名患有多发性硬化症和医源性低丙种球蛋白血症的年轻成年女性，她患有难治性双侧盆腔炎和TOA，通过三种不同的分子检测确定为单一病原体。据我们所知，这是文献中第二例由[具体病原体]引起的TOA病例，也是第一例通过血浆中无细胞病原体DNA宏基因组下一代测序诊断出来的病例。
