Thursday, February 07, 2013


A case of mycoplasma hominis infection on chronic refractory lower leg ulceration caused by livedo vasculopathy

A case of mycoplasma hominis infection on chronic refractory lower leg ulceration caused by livedo vasculopathy


[Article in Japanese]


Clinical Laboratory Department, St. Luke's International Hospital, Chuo-ku, Tokyo 104-8560, Japan.


Mycoplasma hominis is a common inhabitant of the human urogenital tract and most frequently causes diseases of the genitourinary tract. Extragenital M. hominis infections are uncommon, with almost all occurring in immunosuppressed persons or those predisposed due to surgery or trauma. We report a case of non surgical, non-traumatic wound infectioncaused by M. hominis. A 28-year-old immunocompetent woman with livedo vasculopathy had an open wound on dorsum of her right foot with signs and symptoms of infection. However, gram staining of the wound swab demonstrated no microorganisms, and initial bacterial cultures did not reveal any microbial growth. After 2 days of culture, minute translucent colonies were appeared and subsequently identified as M. hominis. She was successfully treated with levofloxacin(LVFX). For the patient's being immune-competent, this infection seems to need a substantial bacterial transfer from the inhabitant organ. The transfer is likely mediated by the fluid's drop, for anatomical locations of vagina and the infection site on leg. Namely, the hinder leg infection is suspected to be caused by continual and heavy bacterial exposure originated from the vaginal M. hominis. This clinical case suggests that infections may occur even in normal immunological status if the site is close to, and lacks anatomical barrier from, the M. hominis inhabitant organ. Especially in infection at chronic refractory lower leg ulceration, M. hominis should be considered as a causative organism.


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