Microbiology
A Ureaplasm. Ureaplasma have 14 serotypes divided into two groups/biovars-Ureaplasma parvum and Ureaplasma urealyticum. There are others in dogs, cats, and other animals.
Epidemiologic Risks
A sexually transmitted disease.
Part of normal genital flora with a colonization rate of 40-80%.
PCR best test.
Syndromes
Urethritis, epididymitis, and prostatitis.
Sterile pyuria. PID? BV? Perhaps mostly biovar 2's.
It can cause invasive disease in those with humoral immunodeficiency, either hypogammaglobulinemia or iatrogenic (anti-CD20 therapy) (PubMed).
Ureaplasma urealyticum can split urea to make ammonia. In immunoincompetent patients, an infection can lead to hyperammonemia with normal liver function (PubMed).
Treatment
Doxycycline 100 mg bid x 7 days; 10% of Ureaplasmas are resistant to tetracyclines, erythromycin 500 mg qid x 7 days.
In urine samples, doxycycline is the most reliable (PubMed).
OR
macrolides such a 1 gm azithromycin.
OR
quinolones, although resistance to EES and ciprofloxacin (35%) is increasing (PubMed).
Notes
Curious Cases
Relevant links to my Medscape blog
Last Update: 10/18/19.