Henmi Yujiro, Kawakami Ken, Sugishima Suzune, Kawai Mayu, Tanaka Hironori, Yamada Masanori, Nakazawa Kei, Koshiba Ryouji, Hirata Yuki, Nishikawa Hiroki
Moriguchi Keijinkai Hospital.
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University.
Nihon Shokakibyo Gakkai Zasshi. 2025;122(9):630-636. doi: 10.11405/nisshoshi.122.630.
Mycoplasma genitalium can cause urinary tract infections and nonchlamydial, nongonococcal urethritis. Recent studies have suggested that M. genitalium is associated with sexually transmitted diseases, particularly among men who have sex with men. Herein, we report a case of M. genitalium infection where treatment related changes in the endoscopic image of the rectum were documented. A 21-year-old male presented to our hospital with bloody stools and fever. Lower gastrointestinal endoscopy revealed multiple rectal erosions and ulcers, and the patient was diagnosed with proctitis. Blood and tissue tests showed no findings suggestive of syphilis or cytomegalovirus infection, and polymerase chain reaction testing confirmed a diagnosis of M. genitalium-induced proctitis. Sitafloxacin (200mg/day) was administered for 2 weeks, after which the bloody stools and fever resolved. Lower gastrointestinal endoscopy confirmed improvement in the rectal lesions, and the patient was discharged from the hospital. To date, no reports have described endoscopic images of M. genitalium-induced proctitis. This was a valuable case in which we followed the treatment progression of M. genitalium-induced proctitis endoscopically.