• Müçteba Enes Yayla, Emine Uslu Yurteri, Murat Torgutalp, EroğluDidem ŞahinDŞDepartment of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Ankara University, Ankara, Turkey., Serdar Sezer, DinçerAyşe Bahar KeleşoğluABKDepartment of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Ankara University, Ankara, Turkey., GülöksüzEmine Gözde AydemirEGADepartment of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Ankara University, Ankara, Turkey., Mehmet Levent Yüksel, Recep Yılmaz, Aşkın Ateş, Tahsin Murat Turgay, and Gülay Kınıklı.
• Department of Internal Medicine, Division of Rheumatology, , Ankara Training and Research Hospital, Ankara, Turkey ; Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Ankara University, Ankara, Turkey.
• Turk J Med Sci. 2022 Dec 1; 52 (6): 188118881881-1888.

BackgroundSystemic sclerosis (SSc) is a chronic systemic disease characterized by vascular damage, autoimmunity, and fibrosis in the skin and internal organs. In this study, we tried to determine the causes of severe infection in patients with SSc and to reveal the factors associated with severe infection.MethodsWe retrospectively examined 214 SSc patients between January 2010 and August 2020. Forty-seven patients with at least one severe infection and 167 patients without severe infection were compared.ResultsA total of 76 episodes of severe infections were detected in 47 (22%) patients. Common infections included pneumonia, infected digital ulcer, urinary tract infections, and osteomyelitis. Female patients had a higher frequency in the group without severe infection (91.6% vs. 80.9%, p = 0.035). Patients with severe infections had a higher frequency of digital ulcers (p < 0.001), cardiac (p = 0.002), and GIS involvement (p < 0.001). In multivariable analysis, digital ulcer presence (OR: 2.849 [1.356-5.898] (p = 0.006) and cardiac involvement (OR: 2.801 [1.248-6.285]) were associated with severe infection. Of the patients with severe infections, 34% had recurrent severe infections. There was no difference in demographic and clinical characteristics between patients with recurrent and nonrecurrent severe infections.DiscussionThe presence of digital ulcer and cardiac involvement seem to be associated with a severe infection in patients with systemic sclerosis. In patients with cardiac involvement and digital ulcers, more careful attention may be required for the development of severe infections.

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