Not all bacterial infections follow the rules. Some are harder to detect, slower to respond to standard antibiotics, and capable of lingering in the body for weeks. One such group is Mycoplasma, a class of tiny, cell-wall-deficient bacteria that can cause a wide range of illnesses, from respiratory infections to urogenital diseases.
While Mycoplasma infections are often mild, they can also be persistent, contagious, and underestimated, especially when misdiagnosed as viral or allergic reactions. Here’s what you need to know to recognize the signs, understand the risks, and know when to seek medical care.
What Are Mycoplasmas?
Mycoplasmas are among the smallest free-living organisms capable of reproducing. Unlike typical bacteria, they lack a cell wall, which makes them resistant to many common antibiotics like penicillin.
There are several Mycoplasma species that affect humans, but the most well-known include:
- Mycoplasma pneumoniae – causes respiratory infections such as atypical pneumonia (often called “walking pneumonia”)
- Mycoplasma genitalium – associated with sexually transmitted infections
- Ureaplasma urealyticum – part of the normal flora in some people, but can cause urinary or reproductive tract symptoms in others
These bacteria spread primarily through close contact, respiratory droplets, or sexual transmission depending on the species involved.
Mycoplasma Pneumoniae
One of the most common and contagious forms is Mycoplasma pneumoniae, which typically causes:
- Sore throat
- Persistent dry cough
- Headache and fatigue
- Mild fever
- Chest discomfort
- Occasional ear or sinus infections
Unlike typical bacterial pneumonia, Mycoplasma infections often develop slowly and may not cause severe symptoms hence the term “walking pneumonia.”
It tends to affect children, teenagers, and young adults, particularly in school or dormitory settings. Outbreaks are most common in fall and winter.
Mycoplasma Genitalium and Ureaplasma
Mycoplasma genitalium and Ureaplasma urealyticum are sexually transmitted or opportunistic bacteria that can colonize the urethra, cervix, and reproductive tract.
In men, they may cause:
- Urethritis (burning during urination)
- Penile discharge
- Testicular discomfort
In women, symptoms may include:
- Cervicitis
- Pain during intercourse
- Abnormal vaginal discharge
- Pelvic discomfort
- Increased risk of infertility or complications during pregnancy
However, many carriers remain asymptomatic, making these infections difficult to detect without targeted testing.
How Are Mycoplasma Infections Diagnosed?
Because Mycoplasma bacteria lack a cell wall and don’t respond to standard antibiotics, they’re also difficult to detect using traditional lab methods.
Diagnosis may include:
- PCR (polymerase chain reaction) tests – highly sensitive and specific for Mycoplasma DNA
- Serological testing – looks for antibodies but may take time to become positive
- Swabs or urine tests – particularly for urogenital species
- Chest X-ray – if atypical pneumonia is suspected
If symptoms linger for more than a week or do not improve with standard treatment, further investigation is essential.
Treatment Options
Because Mycoplasmas lack a cell wall, they do not respond to beta-lactam antibiotics (such as penicillin or cephalosporins). Instead, treatment typically involves:
- Macrolides (e.g., azithromycin) – especially for children or respiratory infections
- Tetracyclines (e.g., doxycycline) – for adults and urogenital infections
- Fluoroquinolones (e.g., levofloxacin) – sometimes used in resistant cases
Treatment length may vary from a few days to several weeks, depending on the species and severity of infection.
When to See a Doctor
Mycoplasma infections often fly under the radar especially if symptoms are mild or mimic viral infections. You should seek medical evaluation if you experience:
- A persistent dry cough lasting more than 7–10 days
- Fatigue, chest tightness, or breathing difficulty
- Burning during urination or abnormal genital discharge
- Pelvic pain, menstrual irregularities, or infertility concerns
- Symptoms that return after partial improvement
If left untreated, certain Mycoplasma infections can lead to long-term complications, such as chronic bronchitis, pelvic inflammatory disease (PID), or reproductive issues.
Small Bacteria, Big Impact Don’t Ignore the Signs
They may be microscopic, but Mycoplasma bacteria can have a significant impact on your health especially when misdiagnosed or ignored. Whether it’s a nagging cough that won’t quit or subtle urogenital symptoms, Mycoplasma infections deserve targeted treatment and proper follow-up.
If you’re experiencing unexplained symptoms, the infectious disease and internal medicine specialists at Erdem Hospital offer accurate diagnostics, evidence-based therapies, and discreet care to help you recover fully and protect your long-term health.
