Infections in Patients with Rheumatoid Arthritis: What You Need to Know
Dr Sanat Phatak
Rheumatoid arthritis (RA) is a chronic condition that causes joint pain, swelling, and stiffness. But aside from affecting the joints, RA also makes people more vulnerable to infections. This increased risk comes from both the disease itself and the medications used to treat it. Infections can be serious, but by understanding the risks and taking precautions, people with RA can protect themselves and stay healthier.
Why Are RA Patients More Likely to Get Infections?
RA is an autoimmune disease, meaning the body's immune system mistakenly attacks its own tissues, particularly the joints. To control inflammation and prevent joint damage, many patients take medications like steroids, methotrexate, or biologic drugs. While these treatments help reduce pain and swelling, they also weaken the immune system, making it harder to fight infections.
Additionally, RA itself can increase infection risk. Chronic inflammation can interfere with the body's natural defenses, increasing susceptibility to bacteria, viruses, and fungi. Joint damage and reduced mobility may also contribute to infections, as less movement can lead to poor circulation and delayed healing of wounds. Patients with lung involvement (interstitial lung disease) are at a higher risk for lung infections.
What Infections Should You Watch For?
People with RA should be particularly mindful of the following infections:
- Respiratory infections: Pneumonia, bronchitis, and other lung infections are more common in RA patients. Symptoms include fever, cough, and shortness of breath.
- Urinary tract infections (UTIs): Pain or burning while urinating, frequent urination, and lower abdominal discomfort may indicate a UTI.
- Skin infections: RA patients are prone to cellulitis, an infection that causes redness, warmth, and swelling in the skin.
- Joint infections: Although rare, infections can sometimes occur inside the joints, causing severe pain and swelling.
If you experience any signs of infection, such as fever, chills, unusual fatigue, or worsening joint pain, contact a doctor promptly. Early treatment can prevent complications.
How Can You Prevent Infections?
While infections are a risk, there are many steps RA patients can take to reduce their chances of getting sick:
- Stay up to date on vaccines: Flu shots, pneumonia vaccines, and COVID-19 boosters are especially important for RA patients.
- Wash hands regularly: Handwashing is one of the simplest and most effective ways to prevent infections.
- Eat a healthy diet and stay active: Good nutrition and regular movement support the immune response.
- Avoid close contact with sick people: If someone around you has a cold or flu, try to keep your distance.
- Talk to your doctor before starting new medications: Some RA drugs can increase infection risk, so it’s important to balance treatment benefits with potential risks.
Can RA Flare Up After an Infection?
Yes, infections can sometimes trigger RA flares. When the immune system fights off certain infections, it may also increase joint pain and swelling. Some infections, such as respiratory viruses, have been linked to flare-ups in RA patients. If you notice a worsening of your symptoms after an infection, talk to your doctor about adjusting your treatment plan.
How Does COVID-19 Affect People with RA?
COVID-19 can be more severe in people with RA, especially those taking immune-suppressing medications. Studies suggest that RA patients may have a higher risk of complications, such as pneumonia or prolonged illness. However, vaccines have been shown to reduce the severity of COVID-19 in RA patients. If you have RA, it's important to follow public health guidelines, get vaccinated, and seek medical care if you develop COVID-19 symptoms.
Final Thoughts:
Infections can pose serious risks for people with RA, but being proactive can make a big difference. By staying informed, practicing good hygiene, and keeping up with vaccinations, RA patients can lower their risk of infections and maintain better health. If you ever feel unwell or notice unusual symptoms, don't hesitate to reach out to your doctor.
