Bradshaw Michael J, Cho Tracey A, Chow Felicia C
Partners Multiple Sclerosis Center, Brigham and Women's Hospital and Massachusetts General Hospital, 60 Fenwood Road, 4th floor, Boston, MA 02115, USA.
Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Rheum Dis Clin North Am. 2017 Nov;43(4):607-619. doi: 10.1016/j.rdc.2017.06.009. Epub 2017 Aug 23.
Patients on immunosuppressive therapy for rheumatic diseases are at increased risk of infection. Although infections of the central nervous system (CNS) are less common compared with other sites, patients on broadly immunosuppressive and biologic immunomodulatory agents may be susceptible to more severe, disseminated forms of infection, including of the CNS. Certain key principles regarding infection risk apply across immunosuppressive therapies, including increased risk with higher doses and longer duration of therapy and with combination therapy. Providers should be aware of the CNS infection risk related to immunosuppressant use to help guide best practices for screening and prophylaxis.
接受风湿性疾病免疫抑制治疗的患者感染风险增加。虽然与其他部位相比,中枢神经系统(CNS)感染不太常见,但接受广泛免疫抑制和生物免疫调节药物治疗的患者可能易患更严重的播散性感染,包括中枢神经系统感染。关于感染风险的某些关键原则适用于各种免疫抑制治疗,包括治疗剂量越高、疗程越长以及联合治疗时感染风险增加。医疗服务提供者应了解与免疫抑制剂使用相关的中枢神经系统感染风险,以帮助指导筛查和预防的最佳实践。