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Increased Rates of Infectious Diseases in Fibromyalgia Patients: A Population-Based Case-Control Study
Michal Vinker-Shuster1,2, Eli Magen2,3,4, Ilan Green3,5
1Department of Pediatrics, Assuta Ashdod University Medical Center, Ashdod 7747629, Israel.
Abstract:
Introduction: Fibromyalgia (FM) patients are known to have medical comorbidities. This study characterized the rates of infectious diseases in FM patients compared to the general population. Methods: A nationwide population-based case-control study was conducted, including all patients diagnosed with FM by a rheumatologist compared to a matched 5:1 control group within a large health maintenance organization in Israel (January 2002 to December 2023). Demographic, anthropometric, and health habit data were extracted from medical records as well as the ICD-9 codes of diagnoses related to infectious diseases in 9232 FM patients and 46,160 controls. Infection rates in the FM patients were compared to the controls over a mean follow-up of 6.7 years. Results: The FM patients had a significantly higher incidence of viral, bacterial, fungal, and parasitic diseases compared to the controls. The FM patients had significantly higher odds ratios (ORs) for respiratory/sinopulmonary infections, including upper respiratory tract infections (OR = 1.49), influenza (OR = 1.80), tonsillitis (OR = 1.40), sinusitis (OR = 1.98), otitis media (OR = 1.84), otitis externa (OR = 1.48), and pneumonia (OR = 1.60), all p < 0.01. They also experienced more gastrointestinal infections, including gastroenteritis (OR = 1.40), Helicobacter pylori (OR = 2.05), candidal esophagitis (OR = 7.88), and giardiasis (OR = 3.41), all p < 0.01. They had a higher prevalence of genitourinary infections, including urinary tract infections (OR = 1.79) and pelvic inflammatory disease (OR = 3.17), p < 0.01 as well as skin infections such as abscess (OR = 1.74) and cellulitis (OR = 1.64) and systemic infections such as symptomatic COVID-19 (OR = 1.76) and Cytomegalovirus (CMV) (OR = 1.85), all p < 0.01. Conclusions: The FM patients had a significantly higher incidence of infectious diseases than the general population. Further research is needed to better understand the underlying mechanisms and develop targeted interventions to address infection risks in FM patients.
Insights
Fibromyalgia (FM) patients experience higher rates of infections, including respiratory, gastrointestinal, and genitourinary types, compared to the general population. This highlights a significant increased susceptibility to various infectious diseases in individuals with FM.
Area of Science:
- Rheumatology
- Infectious Diseases
- Epidemiology
Background:
- Fibromyalgia (FM) is a complex chronic pain condition often associated with various comorbidities.
- Understanding the infection risk in FM patients is crucial for comprehensive patient care.
Purpose of the Study:
- To compare the incidence of infectious diseases in fibromyalgia patients versus the general population.
- To characterize the types and rates of infections in FM patients.
Main Methods:
- A nationwide population-based case-control study was conducted in Israel from 2002 to 2023.
- 9,232 FM patients were compared to 46,160 matched controls, analyzing medical records for infectious disease diagnoses (ICD-9 codes).
- Mean follow-up was 6.7 years, comparing infection rates between groups.
Main Results:
- FM patients exhibited significantly higher incidence rates for viral, bacterial, fungal, and parasitic diseases.
- Elevated odds ratios (ORs) were observed in FM patients for respiratory infections (e.g., influenza OR=1.80, pneumonia OR=1.60), gastrointestinal infections (e.g., H. pylori OR=2.05, candidal esophagitis OR=7.88), and genitourinary infections (e.g., UTI OR=1.79, PID OR=3.17).
- Higher prevalence of skin infections (abscess OR=1.74, cellulitis OR=1.64) and systemic infections like COVID-19 (OR=1.76) and Cytomegalovirus (CMV) (OR=1.85) were also noted.
Conclusions:
- Fibromyalgia patients demonstrate a significantly increased incidence of infectious diseases compared to the general population.
- Further research is warranted to elucidate the underlying mechanisms driving this heightened susceptibility.
- Targeted interventions may be necessary to mitigate infection risks in the FM population.
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