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Background <p><i>Mycoplasma hominis</i> and <i>Ureaplasma urealyticum</i> are genitourinary colonizers that can cause extragenital infection after trauma or surgery, yet diagnosis is frequently delayed by negative routine cultures.</p> Case presentation <p>A 60-year-old man developed persistent postoperative infection after decompressive craniotomy for head trauma. Routine cultures were non-informative. Guided by a stepwise protocol (targeted sampling of blood/cerebrospinal fluid (CSF)/wound and urethral reservoir), we detected <i>M. hominis</i> by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)/culture and confirmed disseminated <i>U. urealyticum</i> by species-specific qPCR (multiple sites except CSF). Targeted therapy (doxycycline with levofloxacin) led to clinical resolution.</p> Conclusions <p>In ICU trauma or postoperative patients with culture-negative infection despite β-lactams, targeted testing for mollicutes, combining mycoplasma and ureaplasma culture, MALDI-TOF MS, and species-specific qPCR, can expedite diagnosis and guide effective therapy.</p> Clinical trial number <p>Not applicable.</p>

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Head trauma complicated with multi-site infections of Ureaplasma urealyticum and Mycoplasma hominis: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月10日

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  • Xuchun Bai,
  • Yuchao Sang,
  • Longyan Ke,
  • Minyue Chen,
  • Nanhong Su,
  • Shaoxi Li,
  • Xiaofeng Hong,
  • Shumin Xie,
  • Xinjian Lin,
  • Xintan Chen

摘要

Background

Mycoplasma hominis and Ureaplasma urealyticum are genitourinary colonizers that can cause extragenital infection after trauma or surgery, yet diagnosis is frequently delayed by negative routine cultures.

Case presentation

A 60-year-old man developed persistent postoperative infection after decompressive craniotomy for head trauma. Routine cultures were non-informative. Guided by a stepwise protocol (targeted sampling of blood/cerebrospinal fluid (CSF)/wound and urethral reservoir), we detected M. hominis by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)/culture and confirmed disseminated U. urealyticum by species-specific qPCR (multiple sites except CSF). Targeted therapy (doxycycline with levofloxacin) led to clinical resolution.

Conclusions

In ICU trauma or postoperative patients with culture-negative infection despite β-lactams, targeted testing for mollicutes, combining mycoplasma and ureaplasma culture, MALDI-TOF MS, and species-specific qPCR, can expedite diagnosis and guide effective therapy.

Clinical trial number

Not applicable.