[Question #886] Mycoplasma Hominis

53 months ago
On a recent urine test I was notified that I tested positive for Mycoplasma Hominis (and nothing else).  I had visited my urologist due to slight pain in the testicle.   I have been married for 20 years and have had no other partners than my wife.   I also trust that she has been faithful. 

My Dr. prescribed a treatment of azithromycin and tinidazole.   My questions are 

1.  Is this the proper treatment protocol? 

2.  Is it necessary?   I have read that mycoplasma hominis is naturally occuring in the urinary tracts of almost all people.    (including some posts on this board.  Is that opinion still accurate or has it been disproved) 

3.  How contagious is it?   the DR. is recommending my wife be treated also (with the same treatment) 

4.  How could two monogamous people end up with this infection? 

Thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
53 months ago
Welcome to the forum. Thanks for your question.

Mycoplasma hominis is a normal bateria in the genital tract and entirely harmless. It is not the cause of your testicular pain. Most testicular pain of this sort is due to prostatitis, which is not STD; indeed, most prostatitis isn't due to any known infection, i.e. it is a non-infectious inflammation problem. To your specific questions:

1) I would guess that azithromycin probably is active against M. hominis, but I have never had the need to treat someone for it. 

2) What you ahe read is correct -- it's a naturally occuring bacteria. Based on the information you have provided, I don't see that antibiotic treatment is necessary and I doubt it will help your symptoms. If you have prostatitis, other antibiotics (e.g. ciprofloxacin) sometimes help. But not always; most prostatitis isn't due to any known infection. 

3) See no. 2. You probably have had M. hominis in your genital tract since childhood. Your wife probably also is carrying it, but not because she caught it from you. It won't harm her.

4) Monogamous people normally have M. hominis in the genital tract.

We try to avoid being critical of our questioners' doctors or the care they have received. But unless there is information about your problem you haven't mentioned, I am puzzled by your treatment or what your urologist thinks he is treating you for. I suggest getting a second opinion from another physician. In the meantime, I doubt you have a serious problem or that your wife is at risk for anything.

I hope this has helped. Best wishes--  HHH, MD

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53 months ago
Thank you very much for your very quick response.  I am currently residing outside of the USA and at times am critical of the quality of care available here.  When I asked the same question to the Dr. about M. Hominis being naturally occuring his only response was "it is a unhealthy bacteria that should be treated".

I think we will follow your advice and look elsewhere for the cause of my occasional testicular pain.  

Much appreciated


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
52 months ago
Sorry for this delayed reply.

Your doctor is mistaken, unless there is a misunderstanding e.g. because of language.

Best wishes and stay safe.
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