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671.e2 Mycoplasma/Ureaplasma Infections

Mycoplasma/Ureaplasma Infections
VetBooks.ir Differential Diagnosis

• Dysuria (e.g., stranguria, hematuria)
BASIC INFORMATION
• Lameness • Respiratory infection (pp. 795, 857, 987,
Definition • Neurologic signs and 1006)
Mycoplasma spp and Ureaplasma spp are • Ocular infections (pp. 199, 200, 209, and 464)
extremely small, fastidious bacteria that lack PHYSICAL EXAM FINDINGS • Urogenital infection (pp. 827 and 1030)
a cell wall. Because they are difficult to grow Depends on site of infection but most • Arthritis (pp. 803 and 888)
in culture and because many species are found commonly • Meningoencephalitis (pp. 756, 757, and 903)
as commensal organisms on the epithelial • Conjunctivitis and ocular discharge
surfaces of healthy animals, there is limited • Nasal discharge Initial Database
understanding of the role they play in disease. • Cough, tachypnea and/or respiratory distress • Depends on infected tissue and disease
This chapter excludes the unique hemotropic • Loud bronchovesicular lung sounds or severity
Mycoplasma spp. (p. 438). crackles • Feline upper respiratory infection or infec-
• ± Fever tious tracheobronchitis are often treated
Epidemiology presumptively without further diagnostic
SPECIES, AGE, SEX Etiology and Pathophysiology testing.
Dogs and cats of any age and either sex; respira- • The bacterial class Mollicutes has eight genera,
tory infection, including pneumonia, occurs including Mycoplasma and Ureaplasma. The Advanced or Confirmatory Testing
more often in young animals. Ureaplasma spp, which require access to urea, • Routine bacterial culture to rule out other
are found predominantly in genitourinary bacterial pathogens
RISK FACTORS tissues. • Serologic tests, if indicated, to rule out
Mycoplasma spp infection is often opportunistic • There are over 200 named species within comorbid (or alternative) infections: feline
and follows other infections (e.g., viral or these two genera, but only a minority have leukemia virus, feline immunodeficiency
bacterial respiratory infection), tissue damage been isolated from dogs or cats. virus, canine distemper virus, and others
or injury, or immunosuppression. • Mycoplasma/Ureaplasma spp are often com- • PCR for Mycoplasma spp, often as part of
mensal organisms found on healthy animals an infectious disease diagnostic panel
CONTAGION AND ZOONOSIS at membrane-associated sites, including the • If culture is desired, contact laboratory about
• Crowded conditions such as those found in conjunctiva, the respiratory tract, and the sample collection and processing (difficult
some animal shelters may facilitate spread genitourinary tract. to grow in culture).
of pathogens, although many species are • Due to complicating factors (e.g., difficulties
ubiquitous. in pathogen culture, difficulty in species TREATMENT
• Human Mycoplasma and Ureaplasma infec- identification, difficulty differentiating a
tions involve different species than those causal from commensal role for isolated Treatment Overview
found in pets, although there are rare reports organisms), the precise role of Mycoplasma These pathogens do not respond to any anti-
of zoonotic infection. and Ureaplasma in disease causation remains microbial that works by disruption of bacterial
largely speculative. cell walls (e.g., amoxicillin, cefazolin).
ASSOCIATED DISORDERS • A few members of these genera seem to cause
Upper respiratory infection, lower respiratory disease as primary or secondary pathogens. Acute General Treatment
infection, genitourinary infection, ocular infec- In humans, Mycoplasma pneumoniae is the Supportive care depends on the tissue infected
tion, polyarthritis, skin and soft-tissue infection, causative pathogen of walking pneumonia, and comorbidities (e.g., pneumonia may
meningoencephalitis and evidence points to a role for M. cynos require oxygen supplementation; lameness
as a true respiratory pathogen in pets. due to arthritis may require analgesia). Specific
Clinical Presentation • Although Mycoplasma and Ureaplasma antimicrobials with expected efficacy for the
DISEASE FORMS/SUBTYPES normally adhere to mucosal epithelial cells, treatment of these infections include
Mycoplasma spp (and Ureaplasma spp in the they can disseminate to other sites and cause • Doxycycline 5-10 mg/kg PO q 12-24h
genitourinary tract) are often part of the infection in other tissues if there has been (follow with water to avoid esophageal
normal flora. There is increasing evidence mucosal disruption (e.g., injury). stricture)
that Mycoplasma cynos has a primary role in • Enrofloxacin 5 mg/kg PO or IV q 24h (dogs)
causing respiratory infection of the upper and/ DIAGNOSIS • Pradofloxacin 7.5 mg/kg PO q 24h (cats)
or lower airways, potentially associated with
conjunctivitis (upper airways) or pneumonia Diagnostic Overview Nutrition/Diet
(lower airways). The role of these organisms These smallest of all free-living organisms Cats with upper respiratory infections may need
in other disease processes remains unproven cannot be visualized by Gram stain, and they to be coaxed to eat (p. 67).
or seems to be uncommon (e.g., abscess, do not grow on routine bacterial culture media.
pyothorax, prostatitis, epididymitis, orchitis, Many laboratories do not offer culture for these Possible Complications
arthritis, meningoencephalitis). microbes. Instead, polymerase chain reaction Doxycycline can cause esophageal stricture. Give
(PCR) is used to recognize these organisms. In water following administration of doxycycline.
HISTORY, CHIEF COMPLAINT animals with respiratory infections, the PCR Enrofloxacin may cause cartilage disruption in
Any of the following are possible: test is often found as a part of a comprehensive young dogs and retinal degeneration at higher
• Ocular and/or nasal discharge respiratory pathogen panel. Even when Myco- doses in cats.
• Sneezing and/or coughing plasma or Ureaplasma species are recognized,
• Tachypnea and/or respiratory distress it can be difficult to determine whether they Recommended Monitoring
• Reddened eyes/conjunctivitis are the cause of disease. Based on clinical signs

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