Bacterial and fungal infections in rheumatoid arthritis

Abstract

The advent of novel therapeutics for rheumatoid arthritis (RA) has transformed articular improvement and systemic outcomes, but the number of respiratory infections has been increasing in the past decade. Important causes for the elevated susceptibility to bacterial and fungal respiratory infections are mainly due to immune dysregulation of RA, pulmonary comorbidities, and immunosuppressive treatments such as corticosteroids, methotrexate, and biological agents. Pneumonia is the most common infection, and fungal infection is also frequently seen in patients with RA. Respiratory infections in patients with RA are considered important factors that affect not only patient survival but also the development of RA itself. Thus, it is essential for clinicians to have sufficient knowledge of the characteristics of respiratory infections in these settings of RA. Because controlling respiratory infections improves the survival of patients with RA, proper diagnosis and prompt treatment of respiratory infections in these patients are necessary throughout their treatment period.