[Question #1081] M. Genitalium

49 months ago
    I got tested in early July due to some nagging crawling feeling in my urethra and came back positive for mycoplasma genitalium. I was given a Z-pack (500mg day 1, then 250mg days 2-4). My symptoms remained and I was then given Doxycycline 100 mg twice a day for 10 days. My symptoms went away. 
    This week, roughly 2-3 weeks later I am noticing a very mild burn during my morning urination. The "crawling" feeling that led me to get tested initially is not there and it does not burn or bother me at any other point during the day when I urinate or otherwise but I am concerned it is either coming back or is not fully gone, is this possible? I have not had sex since this whole thing started. On my follow up visit they took another urine sample only to tell me that they can't test for MG but my results came back negative in their lab for white blood cells/UTI (why wouldn't they test me for MG again if that's what my problem was??)
   I know this is a new STD and there is limited info out there but in your opinion should I be concerned? I want to get on with my life without fear of giving someone MG. Thank you
   
Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago
Welcome to the Forum.  I'll be happy to comment.  Mycoplasma genitalium is a recently recognized pathogen that can cause urethritis in men.  While azithromycin is one of the antibiotics recommended for treatment of Mg, treatment with at least a single 1.0 gram dose is recommended and some specialists would use 2.0 grams, again given as a single dose is the way to go.  Should that not work the next recommended therapy is with moxifloxacin given daily is the next recommended therapy.  No matter what is being done however, my advice is that BEFORE you start Thurber therapy, you should have a repeat test to make sure that the infection is still present.

I hope this information is helpful.  EWH
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49 months ago
Thanks for the reply. I'll make an appointment for another test.   Just a bit confused about the follow-up urine test they did for UTI/white blood cells, was that pointless or did the negative result mean the MG was cleared?  Are women also at risk with this or just men? 
Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago
The test for white blood cells was reasonable.  Mg is one of the bacteria which causes nongonococcal urethritis and the absence of white blood cells would suggest that your infection may have resolved.  It sounds like you now need a "tiebreaker" test.  If the repeat Mg test is negative, you can know that your symptoms are not due to infection and move on in terms of STIs.  If it is positive, you need more treatment.  Overall it sounds like your doctors are doing the right thing.  

Women can get Mg and women who have been exposed to a recent sex partner with NGU or Mg should receive a dose of azithromycin as described above.  EWH
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