Mycoplasmas are unique bacteria characterized by the absence of a cell wall. Instead, they have a cytoplasmic membrane, which makes them distinct from microorganisms. This feature complicates their detection by the immune system and renders antibiotics targeting the cell wall ineffective.
However, drugs such as tetracyclines and macrolides, which act on other mechanisms like protein synthesis, remain effective against these microorganisms. Mycoplasmas can cause many diseases, including respiratory tract infections, urogenital infections, and chronic inflammatory conditions.
Characteristics of Mycoplasmas
Mycoplasmas are intracellular pathogens, making them similar to viruses. They can “hide” inside the cells of the body, avoiding the immune response and standard diagnostic methods. Their minimal genome allows them to quickly adapt to changes in the external environment and to medications.
These bacteria can penetrate vulnerable systems in the body, including the central nervous system and endocrine organs, disrupting hormonal and immune balance. They often cause chronic inflammation and can trigger autoimmune reactions. Additionally, mycoplasmas frequently accompany other infections, such as Lyme disease, further complicating their detection and
Main Types of Mycoplasmas and Their Characteristics: These species differ in clinical significance, pathogenicity, and the spectrum of affected areas, which defines their diagnostic and therapeutic approaches.
- Mycoplasma pneumoniae
- Diseases: Atypical pneumonia (“walking” pneumonia), bronchitis, pharyngitis.
- Features: Transmitted via airborne droplets, more commonly affects children and young adults but can occur at any age, especially in crowded settings (schools, universities, nursing homes). Symptoms may include chronic cough, headache, fever, sore throat, and fatigue. In some cases, a rash resembling urticaria may occur.
- Mycoplasma genitalium
- Diseases: Urethritis, cervicitis, pelvic inflammatory disease.
- Features: Sexually transmitted. The infection is often asymptomatic but can lead to infertility. In women, symptoms include vaginal discharge or pain during intercourse; in men, discharge from the penis, burning or tingling during urination.
- Mycoplasma hominis
- Diseases: Genitourinary infections, postpartum and post-surgical complications
- Features: Most healthy individuals show no symptoms. It may be associated with complications during pregnancy, such as miscarriages, and fever in newborns.
- Ureaplasma species (U. urealyticum and U. parvum)
- Diseases: Urethritis, urinary tract infections, complications during pregnancy.
- Features: Often present in the microbiota without symptoms but can become pathogenic. Transmitted sexually and may cause discharge, abdominal pain, and an unpleasant odour from the genital area.
Common Symptoms of Mycoplasma Infections
Mycoplasma infections can manifest in various ways depending on their location and species. Among the most common diseases is mycoplasma pneumonia, which affects the respiratory tract. This pneumonia is known as “atypical” or “walking” pneumonia due to its mild course, which differs from traditional bacterial pneumonia. Many patients experience the disease with minimal symptoms, making diagnosis challenging.
Respiratory Symptoms:
- Cough: Dry or with a small amount of sputum, often persistent.
- Fever: Mild elevation, rarely high fever.
- Chest pain: Dull or pressing, related to breathing.
- Shortness of breath: Mild, worsening with physical exertion.
- Hoarseness or sore throat.
Other Symptoms of Mycoplasma Infections:
- Cognitive disturbances: Difficulty concentrating, memory problems.
- Chronic fatigue: Persistent weakness that does not improve with rest.
- Muscle and joint pain: Inflammation of soft and joint tissues.
- Gastrointestinal disorders: Abdominal pain, diarrhea, constipation.
- Skin rashes: Rash resembling “hives” in rare cases.
This list of symptoms is not exhaustive. Mycoplasma infections may present with other, less common symptoms, including neurological disturbances or increased pain in conditions like endometriosis.
Role in Diseases
Mycoplasmas can be both the primary cause and a contributing factor to a variety of diseases.
High Frequency in Patients with Chronic Diseases
Patients with chronic diseases often have an increased susceptibility to mycoplasma infections. This may be due to a weakened immune system that cannot effectively fight infections or the presence of chronic inflammation, which creates favourable conditions for the proliferation of these bacteria. In such patients, mycoplasma infections may progress more aggressively and lead to long-term negative health consequences.
Association with Lyme Disease
Mycoplasmas are also associated with Lyme disease, which is caused by the bacterium Borrelia burgdorferi. Research shows that mycoplasmas can co-infect with borrelia and other pathogens, worsening the course of Lyme disease and complicating its treatment. These co-infections can cause more pronounced symptoms, such as chronic fatigue, neurological disorders, and immune dysfunction. As a result, diagnosis and treatment become more difficult, as mycoplasma infections often remain undiagnosed.
Mycoplasmas and Endometriosis
Although the connection between mycoplasmas and endometriosis is not fully established, some studies suggest that mycoplasma infections may influence the development or worsening of endometriosis. Endometriosis is characterized by chronic inflammation of tissues growing outside the uterus. Mycoplasmas, such as Mycoplasma hominis and Ureaplasma, can exacerbate inflammatory processes, which contributes to the worsening of endometriosis symptoms. This inflammation can cause severe pain and be a cause of infertility in patients with endometriosis.
Transmission Routes and Sources of Infection
Mycoplasma as Part of the Microflora
Mycoplasmas are natural components of the human microflora, commonly found in areas such as the nose, mouth, respiratory tract, and urogenital system. Typically, these microorganisms do not pose a health threat and can peacefully coexist with humans. However, when the immune system is weakened or other unfavourable conditions arise, such as stress, hypothermia, mold presence in the environment, or chronic diseases, mycoplasmas can become pathogenic.
Pathogenicity in a Weakened Immune System
Mycoplasmas may remain asymptomatic or cause minimal symptoms under normal conditions. However, when the immune system is weakened due to factors like chronic diseases, stress, immunosuppressant use, or other conditions, latent infections may be activated. In such cases, mycoplasmas can become pathogenic, leading to various diseases, including inflammatory processes, chronic fatigue, neurological disorders, and other complications.
Spread of Mycoplasmas through the Environment
Mycoplasmas play an important role in the environment, especially in areas with high humidity or poor ventilation, which can facilitate the spread and infection of individuals.
Mycoplasmas in the Air
One of the characteristics of mycoplasmas is their ability to spread through the air in the form of aerosols, particularly in enclosed spaces with poor ventilation. These bacteria can enter the respiratory tract, causing respiratory infections or exacerbating chronic conditions.
High-density places, such as hospitals, offices, residential buildings, and transportation, are particularly vulnerable to this risk. In airplanes, for example, the concentration of mycoplasmas may be higher due to limited ventilation and long periods spent in confined spaces. A further risk factor is the headrests used by passengers, which are rarely sufficiently disinfected, making them a potential reservoir for mycoplasmas and other microorganisms.
Water and Mold
Mycoplasmas can actively proliferate and spread in humid conditions, especially in buildings damaged by water leaks or mold. Water containing mycoplasmas can serve as a source of contamination for humans when it enters drinking water or the atmosphere. Mold, in turn, can be linked to the activation of mycoplasmas in damaged buildings, where increased humidity promotes the survival and reproduction of both mold fungi and mycoplasmas. These microorganisms can exist in biofilms that form on walls, furniture surfaces, or in ventilation systems.
Mold fungi can create an environment that supports the growth of mycoplasmas, thereby increasing the risk of infections, particularly in individuals with weakened immune systems or chronic conditions. This process of mycoplasma activation can exacerbate symptoms of respiratory diseases and other systemic conditions, making diagnosis and treatment more complex.
Mycoplasma Diagnosis
One of the main challenges in diagnosing mycoplasmas is their ability to hide within host cells. They can penetrate cells and exist in a latent (hidden) form, making them difficult to detect using standard methods. This significantly complicates diagnosis, requiring the use of more sensitive and specific techniques.
To identify mycoplasmas, antimicrobial drugs are sometimes used to activate hidden infections. Under their influence, mycoplasmas may transition from a latent state to an active phase, making detection easier. However, this approach must be used cautiously, as it can trigger the exacerbation of symptoms in patients with chronic or hidden infections. It is important to remember that in such patients, mycoplasma is not always the only issue.
Mycoplasma diagnosis remains a challenging task, requiring the use of various methods to accurately identify the infection and ensure effective treatment. Depending on the stage of the disease, combined approaches may be used:
- Clinical Diagnosis — based on the assessment of symptoms such as cough, fever, and weakness, which may indicate a mycoplasma infection.
- PCR (Polymerase Chain Reaction) — a molecular method that detects mycoplasma DNA in biological samples (blood, urine, mucus, or tissues). PCR allows for accurate diagnosis in the early stages when other methods, such as antibody tests, may not be effective. This method also helps identify the type of mycoplasma, which is crucial for selecting optimal treatment. However, PCR requires precise sample preparation, can be expensive, and may not always be accessible.
- Antibody Level Testing (IgG, IgM) — this method may yield false-positive or false-negative results, especially in the later stages of infection or in cases of latent disease.
Thus, accurate diagnosis of mycoplasmas requires a combination of methods to detect the infection at different stages and ensure effective treatment.
Treatment of Mycoplasma Infections
The treatment of mycoplasma infections depends on the form of the disease and the patient’s condition. For acute infections, such as pneumonia or urethritis, the primary treatment method involves antibiotics like tetracyclines, macrolides, or fluoroquinolones. These medications are effective because they can penetrate cells, which is crucial in combating mycoplasmas, as they lack a cell wall like typical bacteria. An additional problem is that almost all groups of these antibiotics have age restrictions and may not always be suitable for treating children.
Moreover, in cases of chronic infections, antibiotics may be less effective because mycoplasmas can hide inside host cells, complicating their elimination. In such cases, treatment requires a comprehensive approach. Along with antimicrobial medications, it is important to use methods aimed at strengthening the immune system, restoring normal microbiota, and detoxification. Anti-inflammatory drugs may also be prescribed for chronic infections, as mycoplasmas often trigger inflammation.
Treating associated conditions, such as chronic respiratory diseases, cardiovascular diseases, or diabetes, also plays a crucial role in the successful treatment of mycoplasma infections. Managing these conditions can help reduce the risk of complications and improve the effectiveness of mycoplasma treatment.
Equally important are aspects of the patient’s overall health: healthy nutrition, adequate hydration, sufficient sleep, regular outdoor walks, and stress management. All these measures help improve immune function and accelerate recovery. More details about these methods can be found in the article: Pain and Discomfort Management for EBV and Other Herpes Infections.
Conclusion
Mycoplasmas are a group of bacteria that can cause chronic diseases, especially in individuals with a weakened immune system. These microorganisms often have a hidden course, making diagnosis and treatment challenging. They can be primary infections or contribute to the development of secondary conditions, such as pneumonia or urinary tract inflammations. Treating mycoplasmosis requires a comprehensive approach, including the use of antibiotics effective against mycoplasmas. It is important to consider the potential resistance of mycoplasmas to certain medications, so diagnostic methods like PCR testing and other modern techniques are crucial for selecting the correct therapy.
Urine can be used for the diagnosis of several infections: Mycoplasma genitalium, Mycoplasma hominis, and Ureaplasma spp. These tests can be ordered at the CirrixDx laboratory, USA.
Blood tests can be performed to detect the presence of antibodies and the immune response to the Mycoplasma pneumoniae bacteria at Armin Labs, Germany.