[Question #3363] Mycoplasma Genitalium

38 months ago
Doctors:

On the ASHA & CDC I recently learned about M. GEN. Although it appears this bacteria is still being studied it can infect the urethra and rectum in gay men.  I have been celibate since 2010 and last time of receptive anal sex was 2006.  I have never been tested for M. Gen and cannot even find a place that will do a rectum test.   From approx '06 - '14 I took a variety of antibiotic treatments for suspected prostatitis. 4 weeks or so of cipro, 4 weeks of doxycycline, at the other times a combination of both. In '08 I was give 1g Azrithomycin and a week or two of doxycycline as preventative measure against exposure to syphils. CDC seems to say a lot of treatment failure with M. GEN. A few questions this new STI to me.  1) absent treatment does the natural immune system clear M. GEN from rectum and urethra, both sites? If so how long? 2) is testing not recommended in asymptomatic people? 3) Would antibiotics I took treated if present? 4) what can happen In males if untreated? Very stressed about this bacteria I did not know about and if CDC is correct it can infect rectum and no way to test.  Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Sigh.  You apparently just can't help yourself and cannot stay of the internet.  You need to get over this. Earlier you indicated you were seeking counseling.  Have you done that?  If not, you need to.  What you do not need to do is to continue to troll the internet for spurious posts that make you think you might have some sort of STI.  Nor do you need testing.  Brief answers to your questions:

1) absent treatment does the natural immune system clear M. GEN from rectum and urethra, both sites? If so how long?
Yes.  Recent studies show that the majority of such infections clear without treatment within a few months of acquisition. These data are limited but his appears to be the case.'

2) is testing not recommended in asymptomatic people?
Correct.  In fact while most experts do agree than M. genitalium can be a cause of persistent urethral discharge, there is much debate as to whether it is an important STI pathogen or not.  The data on this are not clear.  Screening for the infection is not recommended by most experts.

3) Would antibiotics I took treated if present?
Yes, doxycycline, azithromycin and quinolone antibiotics such as ciprofloxacin all have activity against M. genitalium

4) what can happen In males if untreated?

No one knows.  there is little evidence that this infection causes serious consequences.

You need to relax, move on and get over your guilt over past sexual encounters.  Dr. Handsfield said this before.  I said this before.  You are not succeeding in accepting this.  You need to.  EWH

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38 months ago
Hi Dr. Hook,

Thank you for your reply. Yes I did contact a counselor and without going into too much detail as I know this is not a mental health site I am suffering from a bit of reasssurance OCD, we are now trying to figure out why as did not have this before and obviously treat.  I know you must answer a lot of obvious questions over and over again to people like me that are struggling with something that makes them not readily accept answers provided or need extra reassurance. However your medical opinion has helped me form a foundation to know that my concerns are not around an STI.  Not to feed the beast but I would like to close this thread with one final question - it was one I forgot to include on my previous post around proper instructions with rectal swab.  As you noted instructions are all over the board and you provided clarity, the one I forgot was that several sources say to take the swab laterally move along inside of rectum walls.  All I did was insert around 3 cm, rotate the stick a little bit in place and leaves served for about 20 seconds or so and remove. I did not try and laterally move to scrap rectum walls, I would have to think that what I did was sufficient?  Thanks again for the forum, your counsel and compassion. I am off the internet and focused on getting my mind right.
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
The way you describe collecting your specimens corresponds with recommended specimen collection technique and I am confident that the sample you collected was adequate.  With modern test methods, specimen collection has become very simple and quite reliable.  You should be confident in the sample you collected and believe your test results.  EWH
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