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