人型支原体可以是人类泌尿生殖道微生物组的一部分,它是泌尿生殖道感染的常见原因。在极少数情况下,也会引起外生性感染,尤其是免疫功能低下的患者。在这个系列中,我们报告了2例病例,并提供了文献综述。患者1是一名患有弥漫性大B细胞淋巴瘤的61岁女性,在含有利妥昔单抗的化疗和CAR-T治疗后,已发展为人马脊椎盘炎。患者2是一名患有先天性低丙种球蛋白血症的50岁女性,其发展为涉及胸膜的播散性人支原体感染。肌肉,和右脚踝。在患者1中使用左氧氟沙星和多西环素进行10周的抗生素治疗,在患者2中单独使用左氧氟沙星进行6周的抗生素治疗导致感染消退。文献综述确定了另外14例报告低丙种球蛋白血症患者人型支原体生殖器感染的病例。人型支原体也应被怀疑为B细胞免疫缺陷患者的生殖器外感染的病原体,具有持续的临床表现,标准培养阴性感染,特别是关节炎或脓肿形成。即使人源支原体可以在标准细菌培养基上生长,在可疑病例中,应及时使用分子方法进行正确的诊断检查和成功的治疗。
Mycoplasma hominis can be a part of human urogenital tract microbiome, and it is a frequent cause of urogenital infections. In rare cases, it can also cause extragenital infections, especially in immunocompromised patients. In this case series, we report two cases and provide a literature review of extragenital infections caused by M. hominis in patients with
hypogammaglobulinemia. Patient 1 was a 61-year-old woman with diffuse large B-cell lymphoma who, after rituximab-containing chemotherapy and CAR-T therapy, developed M. hominis spondylodiscitis. Patient 2 was a 50-year-old woman with congenital
hypogammaglobulinemia who developed disseminated M. hominis infection involving pleura, muscles, and right ankle. Antibiotic therapy with levofloxacin and doxycycline for 10 weeks in patient 1 and with levofloxacin alone for 6 weeks in patient 2 led to infection resolution. The literature review identified 14 additional cases reporting M. hominis extragenital infection in patients with
hypogammaglobulinemia. M. hominis should also be suspected as an etiological agent of extragenital infection in patients with B-cell immunodeficiency with a clinical picture of persistent, standard-culture negative infection, particularly with arthritis or abscess formation. Even if M. hominis can grow on standard bacterial medium, in suspected cases molecular methods should be promptly used for correct diagnostic work-up and successful therapy.