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Mycoplasma genitalium

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Definition:
Sexuell übertragene urogenitale Infektion mit dem Bakterium Mycoplasma genitalium.
Häufigkeit:
Scheint bei Urethritis, Zervizitis und Pelvic Inflammatory Disease seltener die Ursache zu sein als Chlamydien. M. genitalium ist bei 6–50 % aller infektiösen Urethritiden und bei 10–30 % aller Zervizitiden nachweisbar.
Symptome:
Meist asymptomatischer Verlauf; evtl. urethraler Ausfluss, Dysurie, Unterleibsschmerzen.
Befunde:
Evtl. urethraler Fluor, bei Männern Balanoposthitis.
Diagnostik:
Das Bakterium lässt sich mithilfe eines Nukleinsäureamplifikationstests (NAAT) im Erststrahlurin nachweisen. Evtl. ergänzend: urethraler, vaginaler und zervikaler Abstrich.
Therapie:
Behandlung mit Azithromycin, ggf. gefolgt von Moxifloxacin (Kontraindikationen und Risikoprofil von Fluorchinolonen beachten!). Ersatzmedikament bei Makrolidresistenz: Pristinamycin.
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  • Thomas M. Heim, Dr. med., Wissenschaftsjournalist, Freiburg