Journal Article

Clinical Presentation of <i>Mycoplasma genitalium</i> Infection versus <i>Neisseria gonorrhoeae</i> Infection among Women with Pelvic Inflammatory Disease

Vanessa L. Short, Patricia A. Totten, Roberta B. Ness, Sabina G. Astete, Sheryl F. Kelsey and Catherine L. Haggerty

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 48, issue 1, pages 41-47
Published in print January 2009 | ISSN: 1058-4838
Published online January 2009 | e-ISSN: 1537-6591 | DOI:
Clinical Presentation of Mycoplasma genitalium Infection versus Neisseria gonorrhoeae Infection among Women with Pelvic Inflammatory Disease

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Background. Women with pelvic inflammatory disease (PID) often present with a spectrum of symptoms. The characteristics of nongonococcal, nonchlamydial PID have not been well described. Our objective was to examine the characteristics of Mycoplasma genitalium infection among women with clinically suspected PID.

Methods. We evaluated 722 women who were enrolled in the PID Evaluation and Clinical Health study. Women with M. genitalium monoinfection were compared with women with Neisseria gonorrhoeae monoinfection or Chlamydia trachomatis monoinfection.

Results. Compared with women with gonococcal PID, women with M. genitalium infection were less likely to have elevated systemic inflammatory markers, including an erythrocyte sedimentation rate >15 mm/h (5 [22.7%] of 22 patients vs. 45 [60.8%] of 74 patients; P=.002), a white blood cell count >10,000 cells/mL (4 [28.6%] of 14 patients vs. 42 [64.6%] of 65 patients; P=.018), and an oral temperature ⩾38.3°C (0 [0.0%] of 22 patients vs. 10 [13.9%] of 72 patients; P=.085). In addition, they were less likely to present with mucopurulent cervicitis (9 [47.4%] of 19 patients vs. 60 [83.3%] of 72 patients; P=.001), elevated vaginal pH (P=.018), and high pelvic pain score (P=.014). In contrast, women with chlamydial PID had signs and symptoms that were similar to those in women with M. genitalium infection.

Conclusions. Because symptoms might be mild, women with M. genitalium infection might not seek PID treatment. Further studies are needed to assess the potential reproductive tract sequelae of M. genitalium infection of the upper genital tract.

Journal Article.  4582 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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