Mycoplasma genitalium testing

[nguquestions]

Does anyone know where I could get tested for mycoplasma genitailium in California? I was diagnosed with NGU at an STD clinic 10 months ago (via urethral smear) one week after receiving unprotected oral sex. I tested negative for gono and chlamydia. Treated with 1g azithromycin and one week Cipro. Discharge and burning after urintation disappeared. Had testicular discomfort so I returned a week later. The swab test suggested the NGU was gone. The Dr. gave me two weeks of doxy just in case. I finished this and then developed sensitivity around the head of my penis (that I feel whenever I walk as my penis rubs against my underwear....like my boxers are made of sandpaper) and it appeared like my urehtra was much pinker and puffier than usual. Returned to the STD clinic and he said it was no big deal after another urethral swab and urine test and said I was clean.

My GP gave me metradinazole as well as difulcan (one dose). No change to my penis irritation issues. I tested negative for HSV II (+ for HSV I but I have had this forever). Urologist inspected me and found nothing wrong. Both saw no WBCs in my urine.

So I am out of thoughts as to what could be going on. My only thought at this point is mycoplasma genitalium. Does this sound like a possibility given the symptoms (no lesions/bumps, no discharge, sensitivity/irritation around the coronal edge and slight pinkness at the urethral opening)? I guess I am trying to understand the difference between NGU and mycoplasma genitalium. Does a negative test for NGU via swab mean no mycoplasma genitailium?

I have looked everywhere for a test and found only one place that wil provide it but it is over 220 miles away. I will make the road trip if necessary.

Thanks everyone!!!

[shaken2core]

This a very good question and had been addressed in many studies.  Often times persistent NGU after all those treatments can be caused by M. Gen. just as you suspect.  The difficult part, as you've enocounterd, is getting tested for it.  Testing is usually done in clinical studies or in a few labs via PCR.  You may want to speak to your doctor about this and then he/she can order the test and collect the sampled from you and ship it to the lab for testing.  

The differenece between NGU and M. Gen is that NGU is a condition cause by bacterial infection, M Gen is one of those bacteria that can cause NGU.  M Gen definitely sounds like a possibility given the meds you have taken and the remaining pain.  

There are a couple other antibiotics you can try to clear this up.  Erythromycine may help.  In addition to that you can try Moxifloxacin as a last resort.  This is a very potent druge that can have lasting side effects if you're not concious of them.  You can speak to your doctor about these and see what he thinks.  Please let us know how things go and if you get tested, please let us know what your results are.  Many men are suffering from the same issue.  

[shaken2core]

Here is some reading on M Gen.  Maybe it will help you.  

[shaken2core]

http://aac.asm.org/cgi/content/full/49/12/4993

[nguquestions]

Thanks a ton for your response....and for the article. I have been looking for a private lab to do the testing because my doctors are reluctant to continue to address this with me (despite my pleas). The one lab I found is expensive ($250) and far but I would do anything at this point to resolve this issue.

Just for clarification: you feel that m. gen. is still a possible explanation for my symptoms? I have read a couple of posts from HHH that suggest these symptoms are not something that can be explained by m. gen. and that these are unlikely to represent any ongoing infection of any kind. He seems to say that discharge is the main factor in identifying NGU (which I do not have). In fact, I cant really tell whether my sensitivity/irritation comes from the skin or from a more internal problem (like an ongoing urethral infection).

Assuming that it is m. gen., will this ever clear up on its own? My impression was that many bacterial STDs end up getting healed with or without treatment (of course, treatment is needed to prevent some complications and transmission).

Thanks again.

[shaken2core]

In my opinion based on everything I have read, yes, M. Gen can still be an issue and you don't have to have discharge for it to be present.  

I do not always agree with Dr. HHH views on persistent NGU, but he's a doctor, I'm not.  However, I've read a lot of information regarding persistent NGU and in some cases, M Gen is the cause when further testing is done.  

Can you post the name of lab that you found to do the testing?  

I do not know of any studies that have looked at M Gen clearing up on it's own, so I'm not sure it's possible.  You said it though, the most important thing is treatment to prevent transmission.  

[nguquestions]

Interesting...I guess that is part of my question. Are my symptoms recurrent/persistent NGU or something else entirely. Everything I have read suggests discharge as the main feature of NGU and my STD Dr. was adamant about me being cured. I only bring this up because I wonder if it is possible to have m. gen. lurking and causing different symptoms...like the sensitivity around the corona.

I am going to pursue the testing but I will not be able to for another month or so. Anylabtestnow.com says they can do the test but they do not have a clinic near me.

Based on your reading, should I go with Erythromycine or Moxi? I want something that is going to be effective but not kill me. I see the CDC recommends Erthro as an alternative to azithro and doxy (both of which I have had). Do you have a sense of how effective it is?

Thanks, once again.

[shaken2core]

That short answer is, yes, M gen can be present without discharge.  I'm not sure how likely it is, but it causes about 10% of NGU and is found in men with persistent NGU, even though discharge is not present.  Although the number of men with persistent NGU w/out discahrge who are infected with M Gen.  seems quite low.  

I believe MDLab also does testing for this.  But they are located in NJ.  

http://www.mdlab.com/html/test_menu.html

I have taken both eryth and moxi, and I can tell you that both helped clear up my discharge, but it came back after I finished therapy.  As to which one is more effective?  I know Moxi is supposed to be more effective because of the way it works on the DNA of bacteria, but again, it has very harsh side effects (it has black box warnings).  You may want to start with the eryth first, maybe an extended course.  The UK guidelines say 3 weeks of eryth for persistent NGU.  If that doesn't work, you may want to get the PCR test done to confirm the presence of M Gen before you take moxi.  In all studies I've come across, a 10 day course of Moxi erradicated M Gen 100% of the time.  Azithromycine is also supposed to be very effective against M Gen, so it's a good possibility that you do not have it at all.  However you were given a 1g does, which is less effective than the 5 day course.  

I can honestly tell you that I wish I didn't take Moxi for so long, but I pushed it because I wanted to get better.  In the long run I'm not better and I have lingering side effects.  

Please let us know, or inbox me if you ever test for M Gen and what the results are.  

[T12388help]

I'm in the same boat too. Persisent Ngu after oral sex.  It's been 5 months.  
Azithromycin and doxy failed and I was given moxi which I haven't taken yet.  I actually took moxi for a sinus infection weeks before my encounter not knowing how potent it is. Nothing happened while I was taking them, but in the weeks and months following, I'm suffering from fatigue, weakness, insomnia, nightmares, sore joints and muscles, headache, dry mouth white tongue, dizziness, etc.....
I've tested neg for everything so my doc said it could be myco.
I'm also told by my doc that there is nothing left to take and moxi is practically 100%. I don't know if it's mycoplasma or adverse moxi effects.  I'm in Canada and have no means to test for it here. You mentioned lingering effects of taking moxi... What kinds of things are you suffering from? Seems like the only way to cure myself is take moxi again and risk it hurting me again if it indeed is the reason.  Any advice?

[shaken2core]

In the future you should start your own thread to keep your information in a single post.  You can add a link to other posts.  

You say you have persistent NGU but what are your symptoms?  

Yes, Moxi is very potent and I suffered from and am still suffering from many of the same symptoms you have listed above.  

I would not take Moxi again unless I had tests to confirm the presence of Mycoplasma or any other life threatening infection.  I came to realize that taking this stuff based on a guess could be extremely detrimental to your health.  My advice is to seek testing, even if you have to work with a lab in the U.S.  If you reluctant to do that or cannot do that, you should be treated for Trich, which causes persistent NGU, and get another dose of Azithro at the same time.  Take at least 2 g of azithro as well as 2 g of metronidazole or Tinidazole.  Give this a try and see if it helps.  If that doesn't help, go for testing.  You reacted poorly to Moxi the first time, so you can expect that you will react poorly to it again.  I'm sure you do not want to relive the hell of that.  I wish I never took Moxi.  

[lionskipper969]

Hi,
I have had NSU/NGU for over two years now and have tried all the various antibiotics.I have had no after affects with any of the prescribed antibitoics discussed above but yet I still have it.
I did have a cystoscopy two weeks ago to take samples from the prostate to find the organism that the urologist hopes to find as he has said I have Chonic Prostatitis which is causing my symptoms.
Will find out results from doctor next monday and keep you informed.
Got to say at many times I think this will never go away
Gum clinic have finished with me and said that if I meet someone its not a case of me passing anything on but that they would have to have a full examination as I am to susceptible to any organism that may cause me uethritis.Easier said than done.No idea how to drop that into a conversation when I might meet a lovely lady.So I am staying single but its getting harder to tell my friends that I am not interested anymore.
How great life is.Not

[shaken2core]

This is an interesting case.  Please do keep us informed on what the urologist finds out.  

In addition, you should be fine meeting a 'lovely lady' and having PROTECTED sex.  

Hang in there man, you're not alone.

[T12388help]

Seems like more than a few people have this problem.  At this point I'm wondering if this is incurable.  Are we supposed to keep cycling through courses of antibiotics hoping one works?
Facing the prospect of having this and being contagious forever is destroying my life.
For me Its so hard to not just go ahead and take
moxi and be done with this ordeal.  But others have taken it and it still persists.  You had adverse reactions while on them that never went away? What specifically happened?  The fact that they can permanently mess you up with no
way to reverse it is scary.  but necessary??
I haven't been treated for trich, not sure how likely to get that from oral only but its worth a shot.    
There must be other effective treatments out there for this. I've be scouring the internet looking for the answer. My doc put me on couple weeks of azithro then wants to try augmenten and septra.  Feel like there's no end to this and getting very depressed.  
Testing seems out of reach so it's impossible to know if this is causing my problems, or some of them.

[shaken2core]

You’re correct, sometimes there seems as if there are no answers and nothing definitive, just treatment after treatment.  Unfortunately that’s the way the world of STD’s is.  As I said before, the medical community does not know everything and they do not or cannot test for every bacteria out there, so some times treatment is empirical and based on symptoms without any positive test results.  There are a lot of guys out there who continue to experience persistent NGU or some sort of penile symptoms, and I’m included in that group.  It’s very frustrating, I know.  

Regarding Trich, you should be treated for it, no matter how remote a possibility you think it might be.  Do not believe everything you read on the internet.  You will find all kind of literature that states Trich isn’t passed through oral, however, the only unprotected experience I had was oral.  I had discharge for almost 4 months and took every antibiotic known to man.  My doctor kept telling me Trich was unlikely, and then I finally asked him for treatment and within 3 days my discharge and other symptoms were gone.  The same thing happened to another guy on this forum.  He experienced discharge for over 2 months and nothing stopped it. I recommended Trich treatment and he was cleared up in a week.  All the literature, people on this site, and even the doctors on this forum state Trich isn’t passed through oral.  Did we have Trich?  No test every confirmed it, but it was the only med that cleared our discharge.  

Yet another example is a guy who contracted Chlamydia from oral and people on this site and the docs on the site state it’s not possible or so rare that oral is not considered a way mode of transmission.  However, within a few days he had posted a recent study that found Chlamydia passed through oral is indeed possible and happens more often than it was previously believed.  

What I’m saying is, don’t rule anything out, no matter how unlikely it may seem.  Anything is possible and you should get treated for Trich to see if it helps.  I didn’t think it would do anything for me, but it cleared my discharge.  

Regarding Moxi- yes, I have lasting symptoms of joint pain, muscle weakness, and tendonitis.  Like I said, you can try it, but without a confirmed diagnosis, you may be putting your long term health at risk for no reason at all.  I would continue to work with other antibiotics first and if you have sex, always make sure it’s protected.  

[lionskipper969]

Hi,
I have been given every treatment available including Moxi with no side effects.Just lucky I guess.I personally will try any antibitiotic going to try and get rid of this.When the clinic gave me Moxi he did say that it was the atom bomb of antibiotics and as that did not work he will not give me anymore.I think when I see my doctor on Monday I bet he will say that the Cystoscopy found no strange bacteria in my prostate and just learn to live with it.
I do not think anything more can be done and I am on anti depressants at the moment as I am struggling big time.
Thanks shaken2core for saying that I can meet someone else but I have a couple of times over the last year and had to walk away as I will never be able to tell someone I meet that I have an STD but safe sex will be ok.
Getting tired of people aking me why I am not with anyone.Tried to talk to my best friend of 22 years about this who got drunk at my birthday party and decided to shout out that I had been in and out of the clap clinic.Lots of people I do not see or talk to anymore because of that.
I use to be a strong man and think I could handle anything.I am beat.

[T12388help]

So if no bacteria that they test for can be found, and you've been thru several courses of antibiotics, at what point can you consider yourself not contagious?  I'm struggling with this now and wondering if I have something u can pass on and how would I even know if that were the case. I have no discharge just inflammation swelling around opening. No bacteria can be grown from my sample.  It's been difficult to find testing for mycoplasma for me(impossible) so I don't think I have any choice but to treat for it.  Unless the symptoms go away, how can I be sure? Those out there with persistent symptoms and failed treatmentsand no answers, do you consider yourself a permanent std carrier? Are you infectious? At what point are you all clear?  Im finding it hard to accept this fate. Have to keep  trying different antibiotics until something works. Something has to work. I know treatment isn't clear cut but if this is happening to so many people why can't there be better testing and help with this?
Does a PCR use blood or urine? Maybe I will try a lab in the US like Shaken said.  I'm sure getting a blood sample to the States would be time sensitive and expensive.   

[lionskipper969]

Hi,results from cystoscopy were no infection found.I wish they found what is causing my Nsu/ngu.
I think I will go back to the gum clinic and talk to them and maybe go private as they do PCR testing.

[lionskipper969]

Hi,
Spoke to a doctor from a top private clinic yesterday on the phone.Expensive phone call.I remember being told you cannot put a price on health but private clinics certainly do.
Explained my two years of Nsu/Ngu.
Doctors thoughts are:
Stop taking general meds:Easy my doc and gum clinic are not giving me anymore.
Go to his clinic and have a PCR test done as gum clinic do not check for everything.i.e Herpes? I thought they did.But the others mycoplasma etc we know they do not check specifically for that and others.
Told me I should seriously consider herpes as a cause.?
Have a trial of Herpes supressants.
No sign to me ever of that and surely cystoscopy would have noticed something.
Regarding prostate;
Have another DRE exam as I was told mine was very tender last time and could be Chronic prostatitis but cystoscopy found no infection and I have no usual prostate problems at all.
Have an MRI scan of pelvis to check tissues etc to see if there is any problems.
Have a rectal ultrasound.
Have your seminal vesicles checked and an image made of your prostate.
He said if the PCR test comes back negative then I should consider myself not to have an STD and start to think about Alkalizing my urine etc
Well after two years and no better I am told to try all that.My urologist appointment is every three months for reasons I do not understand and I bet he will not put me up for most of them tests.
I will be paying privately for the PCR Tests but I could not afford the rest privately.
Still amazes me that clinics do not do PCR tests and after a while basically tell you to stop coming back and work with a urologist who seems very slow in trying to help me out.I have been seeing him a year and all I have had is a cystoscopy.
It will take me another five years at this rate to have the other tests done even if he can be bothered.
Keep you informed.

[lionskipper969]

Hi,
Shaken2core,my last post may be of interest to you.Even  though its long.

[shaken2core]

Hey Lion - was not aware this post was still going until you alerted me.  As far as Herpes goes, I can say with 99.99% certainty that it's not the cause.  It would not give you persistent NSU for 2 yrs because Herpes comes and goes.  What other PCR tests does he want you to have done?  You've taken Moxi, so it can't be M. Gen.  You've pretty much been tested for everything and you've taken every effective antibiotic available.  My view is still the same, guys like you, T12388help, myself, and others in our shoes are battling some kind of residual effect, caused by some unknown bacteria or inflammation persists for one reason or another.  I find it difficult for inflammation to persist so long without a causative agent.  I would say this is something we need to live with and hope our immune systems will eventually kill this off and our bodies will repair themselves.  The medical community has no answers for us, but hopefully in time, with more research, they will discover more causative organisms that cause NSU and/ or develop an effective antibiotic to combat this.  

Do I think you guys are contagious and would be passing some devastating STI onto a partner?  No, I think you guys should be fine and should pursue relationships and not be affraid to have sex.  Always use protection for your own safety and your partner's safety, and you should be fine.  I'm living proof of this, and I've been where you guys are going, and I've finally been able to break through my fears and begin sexual relations with my partner again without causing her adverse health affects.  

I really feel bad for you having to wait so long for medical attention.  I'm assuming you're in the UK and that you're on public health care?  Here in the U.S. ,I got all the testing you described, plus some, within 1.5 months.  

Hang in there and be persistent.  Remember that doctors dont know everything,especially urologist and STD's, so keep doing your research, bring it with you to your appointments and discuss other possibilities and treatments.  Hopefully you have a good doctor who is open and willing to consider everything, and who will work with you to figure out what's going on.  As always, keep us updated.  

[hanger]

Hi Bro,How r u?
Guys(lionskipper969,T12388help) I am in the same boat as u.shaken2core knows about my case.Here is My case: I had sex with a prostitute both oral and vaginal with condom,but right from the next day I had burning upon urination 2 days later I started getting pain in right testicle.The pain persisted for 1month 24/7,then after 1month I started having pain in my left testicle(still suffering).

COMING TO DOCTOR VISITS&TESTS I HAVE SO FAR:
* Tested at 9 days after exposure for G,C,HEP A,B,C,HIV,HERPES1,2 All negative
* Tested at((PLANNED PARENTHOOD) on 18th day  for G&C --negative.
*19th day after exposure went to UROLOGIST,he prescribed azithromycin(1g) ORAL,ciproflaxacin(2/day,10days).
* 21st day went to different STD clinic,they did urinalysis and to my surprise they said they found WBC's which indicates some infection and gave ceftrioxin shot(250 IV) and said to continue the medication prescribed by UROLOGIST,tested for G&C again on the same day-result was negative.
*After finishing ciproflaxacin,I still had pain in My testicles and I got a new symptom i.e,pressure in lower left abdomen(bladder may be??), went to UROLOGIST.In Urinalysis he found both WBC'S AND RBC'S,said to go for XRAY(KUB) suspecting kidney stones,he also prescribed some anti inflammatory medicine,I asked him to treat for trich just in case so he prescribed metrodizle(2grams) oral.taken the XRAY and medication,no change in My symptoms.After 2days doctor called me and said the XRAY looks normal(no kidney stones)
*As symptoms still persisted I did go to STD CLINIC,they did check my penis and testicles said nothing looks abnormal and told me to take ibobrufein for 10 days for the pain WTF
*I visited UROLOGIST again,told him I have a new symptom that is the My first urine of every day is brownish red in color.He did cystoscopy, said everything looks normal and asked me to take CT SCAN for abdomen and pelvis just in case and asked me to relax?
* After 2 days DOC called me and said he got CT SCAN results,and he did not find anything abnormal.
*This is 9th week of exposure,did take a 8 panel test 2days back,waiting for the results.
Guys,I am depressed,lost My job,don't want to talk to any body,crying all day,I think this is invading My life.Oh God but I'm only 25

[shaken2core]

Hang in there bro (no pun intended).  Please know that it took 3-4 months for my major symptoms to  subside.  I'm left with residual symptoms at this point.  It will take over your life because it's something you will think about and stress out about on a daily basis, but continue to fight the depression, things will get better.  

[T12388help]

Hey Hanger,
I know personally how hard it can be. It can wear on you and consume your life.  Try your best to hold out hope for this to end or at least become manageable..  It may be a part of your life for however long but know it will get better. I know the depression can be brutal, it can be as bad or worse than the physical problem so try not to fall down that hole too far.  It will be ok.  Shaken's experience gives me hope that life can still go and be good for guys like us with this problem.  

[T12388help]

Hi Shaken,
Was wondering about where you had testing done for M Gen.  As I mentioned, I'm in Canada and from what I've seen there is no PCR testing up here.  Tried to contact a lab in the States, no word yet. Finding a lab to help me from here is proving difficult.  Aside from testing, how can I be sure I don't have it?  If I've taken azithro and doxy can I be considered M Gen. free?  My concern is that they aren't 100% as there are failures with these treatments.  Which takes me back to Moxifloxicin.  Is it the only way to take M. Gen. off the table without testing?  I've been searching like crazy for an antibiotic that is as effective against mycoplasma.  I see my infectious diseases specialist soon.  Not sure what to ask for as I just went thru 2 week doses of azithro, Augmentin, and Septra.  He seems to have no further answers for me.  I'm definitely going to ask for treatment for Trich as you suggested.  I've read about other classes of antibiotics that might work, but they are either really expensive or only by IV.
I'm considering Cipro.  have a feeling it will come down to me taking Moxi. If it doesn't work at least I can be sure Bacteria is ruled out.  I've done hours of research on this. Was also thinking about anti fungal treatments like difflucan. Parasitic  possibly?  have you tried them all?
I'm holding off being intimate with my partner after making a mistake and it's maddening to not know if I have something or not. It's been 6 months.  This problem, coupled with the guilt, has been the hardest time in my life.  

[craig457]

To shaken2core, T12388help, lionskipper969

do you guys mainly have urethra pain?  what about prostrate pain?  I've been on about everything known to man since last May except an extended course of zithro (1g one time).  Currently taking 1g of tindamax for 7 days.  Have taken standard STD tests, PCR for Trich and urea/myco all of which have come back negative.  I've read thought that you need to be antibiotic free for 4 weeks for these tests to be accurate.  I'm at the end of my rope too.  I'm 38 and was in excellent health before this nightmare that wont' go away.  any suggestions or success stories would be welcomed.