J Korean Rheum Assoc.
1999 Sep;6(3):253-259.
Two Cases of Aspergillosis in Systemic Lupus Erythematosus
- Affiliations
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- 1Division of Rheumatology, The Catholic University of Korea, College of Medicine.
- 2Department of Internal Medicine, The Catholic University of Korea, College of Medicine.
Abstract
- Invasive infections with Aspergillus species may occur in patients with severe immune deficits and have been described rarely in systemic lupus erythematosus. We present two cases of pulmonary aspergillosis in steroid-treated systemic lupus erythematosus(SLE). Both patients had active SLE treated with high dose corticosteroids and prescribed with broad spectrum antibiotics. One patient had combined infection with pulmonary tuberculosis and the other present granulocytopenia. The diagnosis was delayed because symptoms and radiologic findings were confused with lupus pneumonitis and bacterial infections. This was similar to those reported previously. Diagnosis was confirmed by identification of the typical septated hyphae within tissue. We prescribed high dose amphotericin B to both patients. But one died with sepsis. Aspergillosis should be suspected in patients with active SLE who are immunocompromised and sustain concomitant bacterial infections. More aggressive diagnostic investigation and treatment may be needed to improve poor prognosis.
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