Clinical presentation of Mycoplasma genitalium Infection versus Neisseria gonorrhoeae infection among women with pelvic inflammatory disease.
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 > or =38.3 degrees C (0 [0.0%] of 22 patients vs. 10 [13.9%] of 72 patients; (P = .001). 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.
Short
Vanessa L
VL
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA. shortv@edc.pitt.edu
Totten
Patricia A
PA
Ness
Roberta B
RB
Astete
Sabina G
SG
Kelsey
Sheryl F
SF
Haggerty
Catherine L
CL
D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D001799:Blood Sedimentation; D001831:Body Temperature; D002690:Chlamydia Infections / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007958:Leukocyte Count; D009175:Mycoplasma Infections / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology*; D045704:Mycoplasma genitalium / Q000302:isolation & purification; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D000292:Pelvic Inflammatory Disease / Q000382:microbiology* / Q000503:physiopathology*; D017699:Pelvic Pain / Q000209:etiology; D002575:Uterine Cervicitis / Q000473:pathology; D014621:Vagina / Q000737:chemistry
D015415:Biomarkers