类风湿关节炎患者的复发性皮肤感染:IL-6信号通路阻断的重要作用:基于病例的综述
Recurrent Cutaneous Infection in a Patient with Rheumatoid Arthritis: The Potent Role of IL-6 Signaling Pathway Blockade: A Case-Based Review.
作者信息
Pieta Antigone, Venetsanopoulou Aliki I, Kittas Christos, Christaki Eirini, Voulgari Paraskevi V
机构信息
Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece.
Microbiology Laboratory, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece.
出版信息
J Fungi (Basel). 2023 Jun 18;9(6):683. doi: 10.3390/jof9060683.
Rheumatoid arthritis (RA) patients deal with a higher risk of bacterial and fungal infections compared to the general population because of their dysregulated immune system as well as the immunosuppressive therapy they usually receive. spp. is a fungal pathogen responsible for cutaneous, lung, central nervous system, and eye infections, mostly in immunocompromised patients, leading to death in disseminated cases. We report the case of an 81-year-old woman with rheumatoid arthritis treated with steroids and an IL-6 inhibitor who was diagnosed with scedosporiosis of the upper limb. She was treated with voriconazole for one month, which was discontinued due to adverse events, and when scedosporiosis relapsed, she switched to itraconazole. We also reviewed the current literature on RA patients presenting with infections. Early and accurate diagnosis of scedosporiosis has therapeutic and prognostic implications, as traditionally this fungus is resistant to commonly used antifungals. Clinical alertness regarding uncommon infections, including fungal, in patients with autoimmune diseases on immunomodulatory agents is essential for effective treatment.
类风湿性关节炎(RA)患者由于免疫系统失调以及通常接受的免疫抑制治疗,与普通人群相比,面临更高的细菌和真菌感染风险。spp.是一种真菌病原体,主要导致免疫功能低下患者的皮肤、肺部、中枢神经系统和眼部感染,在播散性病例中可导致死亡。我们报告了一例81岁的类风湿性关节炎女性患者,她接受了类固醇和IL-6抑制剂治疗,被诊断为上肢赛多孢子菌病。她接受伏立康唑治疗一个月,因不良事件停药,赛多孢子菌病复发时,她改用伊曲康唑。我们还回顾了目前关于出现感染的RA患者的文献。赛多孢子菌病的早期准确诊断具有治疗和预后意义,因为传统上这种真菌对常用抗真菌药物耐药。对于接受免疫调节剂治疗的自身免疫性疾病患者,对包括真菌在内的罕见感染保持临床警惕对于有效治疗至关重要。
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