{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:30:33Z","timestamp":1791379833316,"version":"4.3.3"},"reference-count":22,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Ureaplasma parvum is usually part of the normal genital microbiota. Rarely, it can cause invasive infections such as septic arthritis or meningitis. A case of a 74-year-old woman with follicular lymphoma who developed cellulitis followed by elbow arthritis with negative routine bacterial cultures is described. U. parvum was identified in the synovial fluid using a broad-range 16S ribosomal RNA gene polymerase chain reaction (PCR) and also in vaginal fluid by a targeted PCR (Anyplex\u2122 II STI-7). Multilocus Sequence Typing (MLST) revealed that isolates from both sources belonged to ST4, a worldwide distributed clone. Treatment consisted of surgery and targeted antibiotic therapy with doxycycline and azithromycin. Evolution showed initial clinical improvement in arthritis despite functional sequelae. Ureaplasma arthritis should be considered as a rare cause of arthritis in negative culture, especially in immunosuppressed patients. In these cases, the treatment is not well established, but according to this and previous works, patients could improve with doxycycline, azithromycin or fluoroquinolone therapy on a prolonged basis.<\/jats:p>","DOI":"10.3390\/diagnostics12102416","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T01:52:21Z","timestamp":1665193941000},"page":"2416","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Ureaplasma parvum Septic Arthritis, a Clinic Challenge"],"prefix":"10.3390","volume":"12","author":[{"given":"Carlos","family":"Su\u00e1rez-Cuervo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario de Cruces, 48903 Bilbao, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concepci\u00f3n","family":"Nicol\u00e1s","sequence":"additional","affiliation":[{"name":"Department of Haematology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Fern\u00e1ndez-Su\u00e1rez","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Morilla","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7081-0936","authenticated-orcid":false,"given":"Javier","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain"},{"name":"Traslational Microbiology Group, Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain"},{"name":"Research & Innovation, Artificial Intelligence and Statistical Department, Pragmatech AI Solutions, 33001 Oviedo, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Respiratorias, 28220 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4044-8235","authenticated-orcid":false,"given":"Luis","family":"Caminal-Montero","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain"},{"name":"Group of Basic and Translational Research in Inflammatory Diseases, Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1128\/CMR.18.4.757-789.2005","article-title":"Mycoplasmas and Ureaplasmas as Neonatal Pathogens","volume":"18","author":"Waites","year":"2005","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e12","DOI":"10.1097\/IPC.0000000000000752","article-title":"Identification of Ureaplasma Parvum as a Cause of Culture-Negative Septic Monoarthitis Using 16S RRNA Gene Sequencing","volume":"27","author":"Suknuntha","year":"2019","journal-title":"Infect. Dis. Clin. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4793","DOI":"10.1128\/AAC.00671-16","article-title":"Antimicrobial Susceptibility and Clonality of Clinical Ureaplasma Isolates in the United States","volume":"60","author":"Karau","year":"2016","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Garc\u00eda, R., Rodr\u00edguez-Esteban, M.\u00c1., Fern\u00e1ndez-Su\u00e1rez, J., Morilla, A., Garc\u00eda-Car\u00fas, E., Telenti, M., Morales, C., Albaiceta, G.M., and Fern\u00e1ndez, J. (2021). Evaluation of 16S RDNA Heart Tissue PCR as a Complement to Blood Cultures for the Routine Etiological Diagnosis of Infective Endocarditis. Diagnostics, 11.","DOI":"10.3390\/diagnostics11081372"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Zhang, J., Kong, Y., Ruan, Z., Huang, J., Song, T., Song, J., Jiang, Y., Yu, Y., and Xie, X. (2014). Correlation between Ureaplasma Subgroup 2 and Genitourinary Tract Disease Outcomes Revealed by an Expanded Multilocus Sequence Typing (EMLST) Scheme. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0104347"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"521921","DOI":"10.1155\/2010\/521921","article-title":"Mycoplasma, Ureaplasma, and Adverse Pregnancy Outcomes: A Fresh Look","volume":"2010","author":"Larsen","year":"2010","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/BF01709369","article-title":"Polymerase Chain Reaction versus Culture for Detection of Ureaplasma Urealyticum AndMycoplasma Hominis in the Urogenital Tract of Adults and the Respiratory Tract of Newborns","volume":"15","author":"Wolff","year":"1996","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2013\/168742","article-title":"Rapid PCR Detection of Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum","volume":"2013","author":"Cunningham","year":"2013","journal-title":"Int. J. Bacteriol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.jmii.2017.05.004","article-title":"Prevalence of Cervical Colonization by Ureaplasma Parvum, Ureaplasma Urealyticum, Mycoplasma Hominis and Mycoplasma Genitalium in Childbearing Age Women by a Commercially Available Multiplex Real-Time PCR: An Italian Observational Multicentre Study","volume":"51","author":"Leli","year":"2018","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/RHU.0000000000000248","article-title":"Ureaplasma Septic Arthritis in an Immunosuppressed Patient With Juvenile Idiopathic Arthritis","volume":"21","author":"George","year":"2015","journal-title":"JCR J. Clin. Rheumatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1093\/rheumatology\/36.6.661","article-title":"Mycoplasmal Arthritis in Patients with Primary Immunoglobulin Deficiency: Clinical Features and Outcome in 18 Patients","volume":"36","author":"Franz","year":"1997","journal-title":"Br. J. Rheumatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e236396","DOI":"10.1136\/bcr-2020-236396","article-title":"Rare Case of Ureaplasma parvum Septic Arthritis in an Immunocompetent Patient","volume":"13","author":"Asif","year":"2020","journal-title":"BMJ Case Rep."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Lemoine, L., Le Brun, C., Maillot, F., Thorey, C., Boucaud, A., Lemaignen, A., and Bigot, A. (2021). Dual Ureaplasma Parvum Arthritis: A Case Report of U. Parvum Septic Arthritis Following Contralateral Reactive Arthritis in an Immunosuppressed Patient. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06733-0"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2248","DOI":"10.1128\/JCM.00432-14","article-title":"Ureaplasma parvum Prosthetic Joint Infection Detected by PCR","volume":"52","author":"Farrell","year":"2014","journal-title":"J. Clin. Microbiol."},{"key":"ref_15","first-page":"bcr2017220383","article-title":"Ureaplasma parvum Causing Life-Threatening Disease in a Susceptible Patient","volume":"2017","author":"Korytny","year":"2017","journal-title":"Case Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e307","DOI":"10.1016\/j.ijid.2010.02.2253","article-title":"Fatal Outcome of a Disseminated Dual Infection with Drug-Resistant Mycoplasma Hominis and Ureaplasma Parvum Originating from a Septic Arthritis in an Immunocompromised Patient","volume":"14","author":"MacKenzie","year":"2010","journal-title":"Int. J. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1093\/rheumatology\/keaa358","article-title":"Ureaplasma parvum Bacterial Arthritis of the Elbow in a Patient with Rheumatoid Arthritis Treated with Rituximab","volume":"60","author":"Verhagen","year":"2021","journal-title":"Rheumatology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e239858","DOI":"10.1136\/bcr-2020-239858","article-title":"Periprosthetic Joint Infection with Ureaplasma Parvum Detected by 16S RRNA PCR","volume":"14","author":"Ball","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_19","first-page":"V03220161","article-title":"Ureaplasma parvum arthritis affecting knee, hip, and sacroiliac joint","volume":"184","author":"Christiansen","year":"2022","journal-title":"Ugeskr Laeger"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"6026","DOI":"10.1128\/AAC.00895-15","article-title":"Antibiotic Susceptibility and Sequence Type Distribution of Ureaplasma Species Isolated from Genital Samples in Switzerland","volume":"59","author":"Schneider","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1128\/JCM.44.4.1590-1591.2006","article-title":"Fluoroquinolone Resistance in Ureaplasma Parvum in the United States","volume":"44","author":"Duffy","year":"2006","journal-title":"J. Clin. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"724935","DOI":"10.3389\/fmicb.2021.724935","article-title":"Phenotypic Antimicrobial Susceptibility and Genotypic Characterization of Clinical Ureaplasma Isolates Circulating in Shanghai, China","volume":"12","author":"Ma","year":"2021","journal-title":"Front. Microbiol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/10\/2416\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:47:12Z","timestamp":1760143632000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/10\/2416"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,6]]},"references-count":22,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["diagnostics12102416"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12102416","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,6]]}}}