It would be helpful to know more about the positive test. Specifically, which Mycoplasma?
But I will come back to that. The first and perhaps more important issue is whether you had any STD at all. Your symptoms suggest nongonococcal urethritis (NGU) -- and looking at urine for floating particles (actually called "threads" of mucus, because you might notice they are elongated) is one way to judge whether urethritis might be present. On the other hand, it is unlikely you acquired NGU via a condom-protected exposure. But if your sexual encounter incluced fellatio, that also is a possible source of NGU. Also, 2 days is too soon; NGU generally takes 7-14 days before symptoms start. The early onset suggests gonorrhea or perhaps a virus, like adenovirus (which can be caught by oral sex). Herpes due to HSV-1 (the usual oral strain) also is possible if you received oral sex, but is unlikely without overt herpes blister/sores of the penis. (Gonorrhea tests are highly reliable, so that's really not a concern.)
Now to mycoplasmas. There are several bacteria in the mycoplasma group, and their roles in causing NGU have been the subject of uncertainty for a long time. In the past several years, M. genitalium has been found to be the cause of 10-20% of NGU cases. However, tests for M genitalium are not widely available except for research. However, if the provider who diagnosed you used an especially sophisticated lab, perhaps you had a positive PCR test for M genitalium. In that case, I would take it seriously -- despite my uncertainties above about the condom and oral sex, it likely is the cause of your problem.
No other mycoplasma regularly causes NGU. There is debate about a bacteria called Ureaplasma urealyticum -- which is in the mycoplasma group, despite the different name. However, UU is present in half of all sexually active men, and a positve test is believed by most experts to be meaningless. (For this reason, most STD experts and STD clinics never even test for it.) Finally, there is Mycoplasma hominis. If the lab tested for that, you can forget it. MH never causes disease in men; it carried normally in both men's and women's genital tracts. Like UU, few STD experts ever test for it.
Does any of this matter? Maybe not. All NGU should be treated, and probably you were prescribed an antibiotic. If so, and if your symptoms clear up, that's all that matters. However, if you have M genitalium and your symptoms don't clear up, you might need additional treatment. For example, either doxycycline or azithromycin are normally used against NGU, but azithro is more reliable against MG than doxy is.
To your closing question: You can rely on the negative test results for chlamydia and gonorrhea; a week after exposure is plenty. It takes up to 6 weeks for syphilis blood tests to become positive, but there is no way your symptoms are due to syphilis, and the treatments for NGU would cure it before the infection ever takes hold.
As is now obvious, you have touched on a complex subject -- which undoubtedly is why you have had trouble finding clear information about Mycoplasma in your online searching. But the good news is that all the infections we have discussed are minor problems, with few or no long term health problems once treated. If your symptoms clear up on antibiotics, then I wouldn't worry further about it. The mystery might not be solved, but in the long run, no harm will come. But if you remain concerned or uncertain, call or return to the clinic to clarify 1) whether or not they diagnosed NGU (or perhaps prostatitis?); and 20 what sort of mycoplasma was found.
I hope this helps. Best wishes-- HHH, MD
A positive test for Ureaplasma is meaningless. It is a normal bacteria in the urethra. Test 100 men, with or without suspected STD, and 50 will have positive results.
Hello Doctor,
I just returned from the clinic and confirmed I was tested positive for Ureaplasma Urealyticum. I took another urinalysis and everything showed up normal. The Doctor gave me 2g of Azithromycin and now I am on Minocycline, 100mg twice a day, for the next week.
I was mistaken when I said was tested for Syphilis, as you said, it was too soon for that. Regardless, it sounds like from what you've said, this treatment would kill that off anyhow.
The Doctor said that should do the trick and if I was still worried that I could be tested again four weeks after the treatment was finished.
I grilled him a little more about how I might have caught this. He said it is possible it could be transferred through contact with say a contaminated towel or hand. Does that sound right to you?
Anyhow, thanks very much for your advice. Not to sound like a bigot, but it's comforting to get advice from an American Doctor when you are in a place like this.
I agree it is puzzling and that it is unlikely you acquired any STD, given the apparently correct condom use. Hand-genital contact isn't a likely source, but conceivably could have occurred. One possibility is urethral irritation due to a physical or chemical irritation, such as inflammation from lubricant (especially if it contained a spermicide, like nonoxynol-9). That would also fit with the onset after only 2 days.
Thanks very much Doctor. I am returning to the clinic on Friday to get some more details and will revert with the answers to your questions.
I am still puzzled/concerned though since I did use a condom even when given oral sex. Is there any way I could have contracted any of the above through her fluids on her/my hands and then touching my genintals?