Mycoplasmas as Important Infections in Chronic Illnesses
Although most mycoplasmas are not considered important human
pathogens, some species, such as M. fermentans, M. penetrans, M.
pneumoniae, M. genitalium, M. pirum and M. hominis, among others,
have been closely associated with various human diseasesi [7]. This
does not necessarily mean that these diseases are entirely caused by
mycoplasmal infections but this type of infection is important in
causing much of the morbidity or illness seen in patients with
chronic illnesses.
Do FMSi, CFSi, RA or GWI patients show evidence of mycoplasmal
infections? In a majority of FMS, CFS, RA and GWI patients examined
we and others, principally Dr. Daryl See of the University of
California College of Medicine, Irvine, CA, are finding strong
evidence for mycoplasmal blood infections that can explain much if
not most of their chronic signs and symptoms. In our studies on GWI,
a CFS/FMS-like condition [1], we have found mycoplasmal infections
in about one-half of approximately 400 patients, and these patients
were found to have principally one infectious species, M. fermentans
[8, 9]. Moreover, in over one-half of the 500 civilians with CFS,
FMS or RA that we have examined we are finding a variety of
pathogenic mycoplasma species, such as those listed above, in the
leukocyte fractions of blood samples. The tests that we use to
identify mycoplasmal infections, polymerase chain reaction and
nucleoprotein gene tracking [10], are very sensitive and highly
specific. These tests are a dramatic improvement over the relatively
insensitive serum antibody tests that are routinely used to assay
for systemic mycoplasmal infections. In fact, we have received a
Department of Defense contract to train scientists and physicians to
conduct these tests, and in the second week of January 1988 a group,
including staff from the Armed Forces Institute of Pathology and
Walter Reed Army Medical Center, the University of Texas Medical
School at San Antonio and the University of California, Irvine
School of Medicine, will be arriving at the Institute for Molecular
Medicine for advanced training in mycoplasma detection in blood and
other body fluids.
New Treatments for Chronic Infections Found in FMS, CFS, RA and GWI
The identification of mycoplasmal infections in the leukocyte blood
fractions of a rather large subset of CFS, FMS and RA patients
suggests that mycoplasmas, and probably other chronic infections as
well, may be an important source of morbidity in these patients. If
such infections are important in these disorders, then appropriate
treatment with antibioticsi should result in improvement and even
recovery. This is exactly what has been found [11]. The recommended
treatments for mycoplasmal blood infections require long-term
antibiotic therapy, usually multiple 6-week cycles of doxycycline
(200-300 mg/d), ciprofloxacin or Cipro (1,500 mg/d), azithromycin or
Zithromax (500 mg/d) and clarithromycin or Biaxin (750-1,000 mg/d).
Multiple cycles are required, because few patients recover after
only a few cycles [9], possibly because of the intracellulari
locations of mycoplasmas like M. fermentans and M. penetrans, and
the slow-growing nature of these microorganisms. These responses are
not due to placebo effects, because administration of some
antibiotics, such as penicillins, resulted in patients becoming more
not less symptomatic.
Treatment recommendations for mycoplasmal infections are similar to
those used to treat Lyme Disease, caused by other slow-growing
intracellular bacteria that are difficult to identify and treat.
Interestingly, FMS, CFS, RA and GWI patients that recover after
several cycles of antibiotics are generally less environmentally
sensitive, suggesting that their immunei systems may be returning to
pre-illness states. If such patients had illnesses that were caused
by psychological or psychiatric problems or by environmental or
chemical exposures, they should not respond to the recommended
antibiotics and recover their health.
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