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!!!

[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]

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.  

[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]

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]

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]

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