Inevitable Late Miscarriage Associated with Mycoplasma hominis Bacteremia Following Cervical Cerclage: A Case Report and Literature Review

Dongjie Hao, Aiyun Li, Nan Jiang, Xiangzhe Huang, Yaqi Qian, Bo Zhu Department of Laboratory Medicine, Women’s Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, 130006, People’s Republic of ChinaCorrespondence: Bo Zhu, Department of Laboratory Medicine, The Women’s Hospital School of Medicine Zhejiang University, Xueshi Road, Shangcheng District, Hangzhou, 310006, Zhejiang, People’s Republic of China, Tel +86-15857153226, Email [email protected]: Mycoplasma hominis (M. hominis) is predominantly isolated from the genitourinary tract; however, the incidence of extragenital infections has risen notably in recent years. Despite this trend, bloodstream infection caused by M. hominis during pregnancy remains exceptionally rare. Due to its fastidious nutritional requirements, this organism is rarely detected by conventional blood culture systems. Furthermore, the inherent absence of a cell wall confers resistance to many first-line antimicrobial agents, thereby complicating the diagnosis and management of M. hominis bloodstream infections in pregnant patients.Case Description: A 31-year-old pregnant woman at 17 weeks and 4 days gestation experienced irregular lower abdominal pain due to a dilated cervical canal. This required cervical cerclage. After the procedure, she developed a fever and signs of infection, identified as a severe M. hominis bloodstream infection. This led to the termination of efforts to save the fetus, resulting in a late-term miscarriage.Conclusion: In clinical practice, pregnant patients with cervical insufficiency represent a high-risk population for M. hominis infection, and active pathogen screening is warranted for early diagnosis. Mastery of the antimicrobial susceptibility patterns of M. hominis allows the transition from conventional empirical treatment to personalized precision medicine, which is key to improving cervical cerclage outcomes and ensuring the well-being of both mother and fetus.Keywords: cervical cerclage, Mycoplasma hominis, bloodstream infection, inevitable late miscarriage