Lung Infections in Systemic Rheumatic Disease: Focus on Opportunistic Infections.
Systemic rheumatic diseases have significant morbidity and mortality, due in large part to concurrent infections. The lung has been reported among the most frequent sites of infection in patients with rheumatic disease, who are susceptible to developing pneumonia sustained both by common pathogens and by opportunistic microorganisms. Patients with rheumatic disease show a peculiar vulnerability to infectious complications. This is due in part to intrinsic disease-related immune dysregulation and in part to the immunosuppressive treatments. Several therapeutic agents have been associated to a wide spectrum of infections, complicating the management of rheumatic diseases. This review discusses the most frequent pulmonary infections encountered in rheumatic diseases, focusing on opportunistic agents, consequent diagnostic challenges and appropriate therapeutic strategies.
Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome 00161, Italy. manuela.difranco@uniroma1.it.
Manuela
M
Di Franco
Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome 00161, Italy. lucchino.b@gmail.com.
Bruno
B
Lucchino
Tropical Medicine Unit, Department of Infectious Diseases, Azienda Ospedaliera Universitaria Policlinico Umberto I, Rome 00161, Italy. martinaspaziante@hotmail.com.
Martina
M
Spaziante
Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome 00161, Italy. cristina.iannuccelli@uniroma1.it.
Cristina
C
Iannuccelli
Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome 00161, Italy. guido.valesini@uniroma1.it.
Guido
G
Valesini
Tropical Medicine Unit, Department of Infectious Diseases, Azienda Ospedaliera Universitaria Policlinico Umberto I, Rome 00161, Italy. giancarloiaiani@gmail.com.
Giancarlo
G
Iaiani
D019468:Disease Management; D004198:Disease Susceptibility; D006801:Humans; D009894:Opportunistic Infections / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D011014:Pneumonia / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D012216:Rheumatic Diseases / Q000150:complications* / Q000175:diagnosis; D012307:Risk Factors
anti-tumor necrosis factor (TNF); lung infections; opportunistic infections; pneumonia; rheumatic diseases