Safety issues in vasculitis: infections and immunizations in the immunosuppressed host

Cleve Clin J Med. 2012 Nov:79 Suppl 3:S38-45. doi: 10.3949/ccjm.79.s3.09.

Abstract

Infectious diseases are a significant cause of morbidity and mortality in immunosuppressed patients, including those with connective tissue diseases. Both disease and treatment contribute to a predisposition to infection in immunocompromised patients. Significant infection and morbidity occur in 25% to 50% of these patients with a median mortality of 5.2% due to common bacterial infections, such as pneumonia or bacteremia, and opportunistic fungal infections such as Pneumocystis. The lungs, skin, urinary tract, blood, and central nervous system are commonly affected. Pathogens such as Pneumocystis jirovecii, Histoplasma capsulatum, Aspergillus species, herpes zoster, JC virus, Nocardia asteroides, and Nocardia species are increasingly prevalent in immunocompromised patients. Improved recognition, diagnosis, and prevention of these infections are needed to enhance outcomes in these patients.

MeSH terms

  • Aspergillosis / complications
  • Aspergillosis / diagnosis
  • Aspergillosis / prevention & control
  • Connective Tissue Diseases / complications
  • Connective Tissue Diseases / drug therapy
  • Herpes Zoster / complications
  • Herpes Zoster / diagnosis
  • Herpes Zoster / prevention & control
  • Histoplasmosis / complications
  • Histoplasmosis / diagnosis
  • Histoplasmosis / prevention & control
  • Humans
  • Immunocompromised Host*
  • Immunosuppressive Agents / adverse effects
  • JC Virus
  • Nocardia Infections / complications
  • Nocardia Infections / diagnosis
  • Nocardia Infections / prevention & control
  • Opportunistic Infections / complications
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / prevention & control*
  • Pneumocystis Infections / complications
  • Pneumocystis Infections / diagnosis
  • Pneumocystis Infections / prevention & control
  • Polyomavirus Infections / complications
  • Polyomavirus Infections / diagnosis
  • Polyomavirus Infections / prevention & control
  • Vasculitis / complications*
  • Vasculitis / drug therapy

Substances

  • Immunosuppressive Agents