Somer T, Finegold S M
Third Department of Medicine, Helsinki University Central Hospital, Finland.
Clin Infect Dis. 1995 Apr;20(4):1010-36. doi: 10.1093/clinids/20.4.1010.
Many pathogenic microbes can induce a complex series of immunologic, endothelial-cell, and hemorheological activation cascades and dysfunctions and can cause interactions of various components of the vessel wall with formed and noncellular elements of the blood. These interactions can result in manifold vasculitides. This article reviews the pathogenetic, clinicopathologic, and therapeutic aspects of infection-related vasculitides; it includes a brief discussion of parasitic, drug-related, and immunization-associated vasculitides as well as of the infection-related features of vasculitides of the central nervous system, retinal vasculitides, ecthyma gangrenosum, and erythema nodosum. Viruses are mainly associated with small-vessel vasculitides, whereas bacterial infections affect vessels of all sizes, including the aorta. The vasculitides associated with fungal infection usually are characterized by erythema nodosum and involve large vessels. The search for microbes as causes of or contributors to vasculitides should continue. Infectious vasculitides may become increasingly important as the number of immunocompromised patients grows.
许多致病微生物可引发一系列复杂的免疫、内皮细胞及血液流变学激活级联反应和功能障碍，并可导致血管壁的各种成分与血液中的有形成分和无细胞成分相互作用。这些相互作用可导致多种血管炎。本文综述了感染相关血管炎的发病机制、临床病理及治疗方面；简要讨论了寄生虫、药物相关及免疫接种相关血管炎，以及中枢神经系统血管炎、视网膜血管炎、坏疽性脓皮病和结节性红斑的感染相关特征。病毒主要与小血管血管炎相关，而细菌感染可累及各种大小的血管，包括主动脉。与真菌感染相关的血管炎通常以结节性红斑为特征，累及大血管。对作为血管炎病因或促成因素的微生物的研究应继续进行。随着免疫功能低下患者数量的增加，感染性血管炎可能会变得越来越重要。
