[Question #12575] Mycoplasma Genitalim

6 months ago

I had unprotected vaginal/oral sex with 35 year old woman in Germany twice between 10/14/24 and 11/14/24. 10/29/24 STI Panel - Negative. 1/3/25 Mild Testicular Pain. 1/13/25 Ultrasound of Scrotum, Chlamydia, Gonorrhea and Urine Culture test (Negative). Mild Epididymitis There was some hypervascularity of the left epididymal head. Small fluid collection. 7 days of Keflax 2X a day 500MG. 1/23/25 she told me she had tested for and was treated for “Mycoplasma Genitalim”. Is it possible I have it, would the antibiotic work, can I have sex with GF?

Edward W. Hook M.D.

6 months ago

Mycoplasma genitalium is a rather uncommon STI and a rare cause of epididymitis. Do you know that you were tested for it? If so and the test was positive, Keflex is not the recommended treatment for this infection. If you have M. genitalium, recommended therapy is doxycycline 100 mg twice daily for 7 days, followed by moxifloxacin 400 mg once daily for 14 days. EWH---

6 months ago

10/14 I was tested for: HIV, Chlamydia, Gonorrhea, Syphilis, Herpes II, Hep A, C and C Positive for oral herpes I (had since child). Then Jan 13 for Gonorrhea and Chlamydia + Culture test (Urologist did not suspect STD so I specifically asked for those as they can cause Epidymitis. All tests negative. Dr prescribed me antibiotic before culture results. I have no other symptoms (and had non). Do you think it’s a small chance I have Mycoplasma G? She said he had it but was vague about it. You think it’s safe to have sex with GF without additional test?

Edward W. Hook M.D.

6 months ago

I would not treat you for M. Genitalium unless there was a positive test. Further, like your urologist, I agree that with the negative tests you have having STI-related epididymitis is unlikely. There is nothing you report that suggests a need to abstain from unprotected sex with your GF.

You have 1 follow up remaining. EWH

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