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'''''Mycoplasma''''' is a genus of bacteria that has been associated with [[Chronic Fatigue Syndrome]] (CFS). == In human disease == The ''Mycoplasma'' genus consists of large number of species, many of which are known to infect humans. There are standard documented diseases such as [[atypical pneumonia]] that can be caused by ''Mycoplasma''. There are then a further number of diseases eg, [[Gulf War Illness]],<ref>{{Cite journal | last = Nicolson | first = Garth L. | last2 = Nasralla | first2 = Marwan Y. | last3 = Haier | first3 = Joerg | last4 = Pomfret | first4 = John | date = 2002 | title = High frequency of systemic mycoplasmal infections in Gulf War veterans and civilians with Amyotrophic Lateral Sclerosis (ALS)|url=https://www.ncbi.nlm.nih.gov/pubmed/12383408|journal=Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia|volume=9|issue=5 | pages = 525β529|issn=0967-5868|pmid=12383408|via=|quote= | author-link = Garth Nicolson}}</ref> [[rheumatoid arthritis]],<ref>{{Cite journal | last = Haier | first = J. | last2 = Nasralla | first2 = M. | last3 = Franco | first3 = A.R. | last4 = Nicolson | first4 = G.L. | date = 1999 | title=Detection of mycoplasmal infections in blood of patients with rheumatoid arthritis|url=https://www.ncbi.nlm.nih.gov/pubmed/10402069|journal=Rheumatology (Oxford, England)|volume=38|issue=6 | pages = 504β509|issn=1462-0324|pmid=10402069|via=|quote= | authorlink3 = | authorlink4 = Garth Nicolson }}</ref> which have been speculatively associated with ''Mycoplasma''. === Pneumonia === In the medical community ''Mycoplasma'' is most often associated with the species ''Mycoplasma pneumoniae''. In human diseases, this species generally manifests as an acute respiratory infection. The severity of this infection can range from mild to a more serious pneumonia. Normally the condition will subside after a course of [[antibiotic]]s.<ref>{{Cite journal | last = Kashyap | first = Surender | last2 = Sarkar | first2 = Malay | date = 2010 | title=Mycoplasma pneumonia: Clinical features and management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2893430/|journal=Lung India : Official Organ of Indian Chest Society|volume=27|issue=2 | pages = 75β85|doi=10.4103/0970-2113.63611|issn=0970-2113|pmid=20616940|via=}}</ref> == Chronic Fatigue Syndrome == A small number of published studies have suggested an increased prevalence of ''Mycoplasma'' presence in individuals with [[Chronic Fatigue Syndrome]] as compared to healthy controls.<ref>{{Cite journal | last = Nasralla | first = M. | last2 = Haier | first2 = J. | last3 = Nicolson | first3 = G.L. | date = 1999 | title=Multiple mycoplasmal infections detected in blood of patients with chronic fatigue syndrome and/or fibromyalgia syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/10691196|journal=European Journal of Clinical Microbiology & Infectious Diseases: Official Publication of the European Society of Clinical Microbiology|volume=18|issue=12 | pages = 859β865|issn=0934-9723|pmid=10691196|via=|quote= | authorlink3 = Garth Nicolson | authorlink4 = }}</ref><ref>{{Cite journal | last = Nijs | first = Jo | last2 = Nicolson | first2 = Garth L. | last3 = De Becker | first3 = Pascale | last4 = Coomans | first4 = Danny | last5 = De Meirleir | first5 = Kenny | date = 2002 | title = High prevalence of Mycoplasma infections among European chronic fatigue syndrome patients. Examination of four Mycoplasma species in blood of chronic fatigue syndrome patients|url=https://www.ncbi.nlm.nih.gov/pubmed/12423773|journal=FEMS immunology and medical microbiology|volume=34|issue=3|pages=209β214|issn=0928-8244|pmid=12423773|via=|quote= | author-link = Jo Nijs | authorlink2 = Garth Nicolson | authorlink3 = Pascale De Becker | authorlink4 = | authorlink5 = Kenny De Meirleir}}</ref><ref>{{Cite journal | last = Nicolson | first = G. L. | last2 = Gan | first2 = R. | last3 = Haier | first3 = J. | date = 2003 | title = Multiple co-infections (Mycoplasma, Chlamydia, human herpes virus-6) in blood of chronic fatigue syndrome patients: association with signs and symptoms|url=https://www.ncbi.nlm.nih.gov/pubmed/12887507|journal=APMIS: acta pathologica, microbiologica, et immunologica Scandinavica|volume=111|issue=5 | pages = 557β566|issn=0903-4641|pmid=12887507|via=|quote= | author-link = Garth Nicolson}}</ref> These species include ''Mycoplasma pneumoniae'', ''Mycoplasma fermentans'' and more. Independent work by Dr. [[Garth Nicolson]] has found similar prevalence and symptom patterns and with [[Gulf War Illness]] (GWI) and [[fibromyalgia]] (FM).<ref>{{Cite web|url=http://www.immed.org/Fatigue%20Illness/06.16.2012%20pdfs/Biomed.Ther.-98.4.14s_s.pdf | title = Diagnosis and Treatment of Chronic Mycoplasmal Infections in Fibromyalgia and Chronic Fatigue Syndromes: Relationship to Gulf War Illness | last = Nicolson | first = Garth L. | authorlink = Garth Nicolson | last2 = Nasralla | first2 = Marwan | date = 1998 | website = immed.org|publisher=Biomedical Therapy|archive-url=|archive-date=|url-status=|access-date= | last3 = Haier | first3 = Joerg | last4 = Nicolson | first4 = Nancy L.}}</ref> A later study, by a different group, was unable to detect the presence of ''Mycoplasma'' in either patients with CFS or healthy controls. The authors of this study have advised potential limitations of the patient selection and detection methodology of the earlier studies.<ref>{{Cite journal | last = Vernon | first = Suzanne D. | last2 = Shukla | first2 = Sanjay K. | last3 = Reeves | first3 = William C. | date = 2003 | title = Absence of Mycoplasma species DNA in chronic fatigue syndrome|url=http://jmm.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.05316-0|journal=Journal of Medical Microbiology|volume=52|issue=11|pages=1027β1028|doi=10.1099/jmm.0.05316-0|quote= | author-link = Suzanne Vernon | authorlink2 = | authorlink3 = William Reeves | authorlink4 = | authorlink5 = |via=}}</ref> == Diagnosis == Standard ''Mycoplasma Pneumoniae'' infections are generally detected using antibody tests. Such tests may be insufficient for chronic ''Mycoplasma'' detection and instead PCR tests may be more effective.<ref>{{Cite journal | last = Choppa | first = P. C. | last2 = Vojdani | first2 = A. | last3 = Tagle | first3 = C. | last4 = Andrin | first4 = R. | last5 = Magtoto | first5 = L. | date = 1998 | title = Multiplex PCR for the detection of Mycoplasma fermentans, M. hominis and M. penetrans in cell cultures and blood samples of patients with chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/9778455|journal=Molecular and Cellular Probes|volume=12|issue=5|pages=301β308|doi=10.1006/mcpr.1998.0186|issn=0890-8508|pmid=9778455|via=}}</ref> The reliability of ''Mycoplasma'' testing from specific private laboratories may not be well established. Variation in results may be seen between different labs so discretion may be needed. An example of a private test provider for ''Mycoplasma'' PCR is [http://www.australianbiologics.com.au/prices Australian Biologics]. == Treatment == As the link between ''Mycoplasma'' and CFS is not well established, there is no standard treatment protocol for suspected cases. ''Mycoplasma'' are generally susceptible to antibiotics. There is one published study which suggests long term doxycycline may be effective for CFS patients who are detected with a ''Mycoplasma'' infection.<ref>{{Cite journal | last = Endresen | first = Gerhard K.M. | date = 2003 | title = Mycoplasma blood infection in chronic fatigue and fibromyalgia syndromes|url=https://www.ncbi.nlm.nih.gov/pubmed/12879275|journal=Rheumatology International|volume=23|issue=5|pages=211β215|doi=10.1007/s00296-003-0355-7|issn=0172-8172|pmid=12879275|via=}}</ref> Despite limited evidence, a number of practitioners consider and treat CFS patients who show signs of a chronic ''Mycoplasma'' infection. Treatment usually involves long term antibiotics along with supportive measures. Examples of practitioner protocols are those of [https://vimeo.com/album/3055152/video/110989158 Dr. Richard Schloeffel], [http://www.drgregemerson.com/fact-file/mycoplasma Dr. Greg Emerson] and the late [http://www.treatmentcenterforcfs.com/documents/MECFSTreatmentResourceGuideforPractitioners.pdf Dr. Lerner]. == References == {{Reflist}} [[Category:Infectious agents]] [[Category:Triggers and risk factors]] [[Category:Bacteria]]
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