Gestión del riesgo de infección en niños con artritis

Por Linda Rath | Actualizado el 19 de febrero, 2026  

Aside from the risks of juvenile arthritis (JA) itself, one of the greatest concerns for parents of kids with JA is the risk of infection. Knowing the risk factors for infection in kids with juvenile arthritis — including infection by bacteria, viruses or fungi — can help you keep your child safe.   

What Increases Infection Risk in Kids With Juvenile Arthritis 

When JA is not well controlled, then the immune system isn't working the way it should. Your child may also need more medication when JA is flaring that could further interfere with the body's ability to fight off infections.  

Still, the risk is relatively low for most medications. Although there aren’t any head-to-head studies comparing infections in children and adults with autoimmune arthritis, data from large national registries show that children taking methotrexate or biologics (such as TNF inhibitors) — the most common treatments for JA — have a much lower infection risk than for adults taking the same medications, and not much higher risk than for kids with JA not taking them. 

Which Medications Raise Risk Most? 

Which juvenile arthritis medicines increase infection risk? Systemic corticosteroids, even when taken for a short period of time, can increase the risk of infection. If corticosteroids must be used, it should be at the lowest dose for the shortest time possible. (This does not apply to corticosteroids applied topically or injected directly into the joint.) 

For both adults and kids with arthritis, severe disease activity and co-existing health problems such as heart disease and obesity increase infection risk. 

Fungal Infections  

Doctors should test children for tuberculosis before starting them on a TNF-inhibitor biologic (such as adalimumab, etanercept or golimumab). Children who take these drugs also have a higher risk of fungal infections, though the risk is still low.  

Symptoms of a fungal infection in a child on a TNF inhibitor are different from those in other kids. Cough is a key symptom, so if your child is taking one of these biologic drugs and develops a bad cough that doesn't go away, their doctor should consider fungal infection, not just other common childhood illnesses.    

When To Call the Doctor 

Cough is also one symptom of COVID, along with fever and shortness of breath, so tell your child’s doctor right away if you notice any of these symptoms. 

Cuando los niños con artritis contraen infecciones, como la varicela o la gripe, la enfermedad puede ser más grave que en los niños sin artritis.  

Pero una investigación reciente sugiere que los niños con AJ tienen un riesgo relativamente bajo de infección grave por coronavirus. Los datos de tres bases de datos de reumatología internacionales encontraron que solo el 10% de los niños con artritis idiopática juvenil (AIJ) fueron hospitalizados con COVID-19 y la mayoría no estaba gravemente enfermo. El tratamiento con drogas biológicas, incluidos los inhibidores del factor de necrosis tumoral, tampoco pareció poner a los niños en un riesgo más alto de contraer una infección grave por COVID-19. Los investigadores que estudiaron los datos señalan que estos resultados deberían tranquilizar a los padres. 

One cause for concern: Children who don’t have an autoimmune disease can develop one after a COVID-19 infection. 

COVID and MIS-C 

Although most kids with arthritis don't seem at special risk of COVID-19, any child - even those with mild cases - can develop a rare, very serious complication called multisystem inflammatory syndrome in children (MIS-C). Puede causar una inflamación grave en los órganos y tejidos de todo el cuerpo, incluidos el corazón, los riñones, los vasos sanguíneos, el sistema digestivo, la piel y los ojos. Los síntomas más comunes parecen involucrar el tracto digestivo y el corazón, pero también pueden incluir: 

• Fiebre que dura 24 horas o más 
• Vómitos 
• Erupción cutánea 
• Fatiga 
• Respiración y pulso acelerados 
• Enrojecimiento ocular 
• Dolor de cabeza, mareos o aturdimiento 

Si su hijo desarrolla dolor de estómago intenso, dificultad para respirar o, según el tono de la piel, piel, labios o uñas pálidos o azulados, solicite asistencia médica de emergencia de inmediato. 

Nadie está seguro de qué causa el MIS-C o por qué algunos niños lo contraen y otros no, pero parece ser una respuesta inmunitaria extrema al COVID-19. Some of the first cases were diagnosed as Kawasaki disease, a rare type of vasculitis with many symptoms similar to MIS-C. Subsequent research has shown that while the two have some features in common, they’re separate conditions. 

Most kids recover from MIS-C with treatment — usually a combination of corticosteroids and intravenous (IV) immunoglobulin— but some who have gotten sick very rapidly haven’t survived. 

How to Lower Infection Risk at Home and School 

Parents can help protect their children by making sure they receive age-appropriate immunizations, including an annual flu shot.  

Are vaccines safe for kids with juvenile arthritis? Yes, with some important exceptions: Most children taking arthritis medication should avoid live vaccines (including the chickenpox vaccine, MMR vaccines or the nasal flu vaccine) because the vaccines themselves increase the risk of serious illness.  

Other immunizations, such as hepatitis A, hepatitis B, meningitis and the human papillomavirus vaccinations, are all safe. All members of the household should be immunized to reduce the exposure risk to children with arthritis.  

Desinfectar regularmente las superficies del hogar que se tocan con frecuencia, como las manijas de las puertas y los grifos, también es otra forma de ayudar. Requesting that other shared surfaces - the barre in your daughter's ballet class, the wrestling mats in the school gym, for example - be cleaned, as well, can also help reduce the risk of infection.   

Never stop arthritis medications without first consulting your child's doctor, especially when a child gets sick. Doing so could reactivate the disease and have longer-lasting consequences than most infections. 

Hable con su hijo  

Practicing good hygiene and frequent hand washing are the most important things kids can do to prevent infection. And warn your child about the risks of sharing drinks, food and lip balm. Most kids with arthritis can live like other kids as long as they are aware of risks and parents are watchful.