J Rheum Dis.  2011 Sep;18(3):193-196. 10.4078/jrd.2011.18.3.193.

A Case of Primary Influenza B Pneumonia in Lupus Nephritis Patient on Immunosuppressive Treatment

• Park SY
• Lee JG
• Uhm WS
• Bae SC
• Sung YK

• KMID: 2223149
• DOI: http://doi.org/10.4078/jrd.2011.18.3.193

Abstract

Infectious diseases, particularly pneumonia, remain a major cause of morbidity and mortality in patients with systemic lupus erythematous (SLE), accounting for 30~50% of all death. Because infection appears in various forms in lupus patients, early detection and appropriate treatment is very important. In the case of diffuse infiltration in the whole lung field, we should make a differential diagnosis with drug-induced pneumonitis, interstitial lung disease and pneumonia caused by atypical microorganism infection. In particular, in case of atypical microorganism pneumonia, we usually suspect cytomegalovirus, pneumocystis jiroveci and ebstein-barr virus, but influenza pneumonia is relatively neglected. Here, we report on the case of a 26-year-old female patient with lupus nephritis who presented with dyspnea and diffuse pulmonary infiltration immediately after intravenous cyclophosphamide. She was diagnosed with primary influenza B pneumonia and successfully treated with oseltamivir.

Keyword

Influenza; Systemic lupus erythematous; Pneumonia; Cyclophosphamide

MeSH Terms

Accounting
Adult
Communicable Diseases
Cyclophosphamide
Cytomegalovirus
Diagnosis, Differential
Dyspnea
Female
Humans
Influenza, Human
Lung
Lung Diseases
Lung Diseases, Interstitial
Lupus Nephritis
Oseltamivir
Pneumocystis jirovecii
Pneumonia
Viruses
Cyclophosphamide
Oseltamivir

Figure

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  Figure 1. Chest X-ray and chest computer tomography show diffuse patch ground glass opacity in both lung fields.

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  Figure 2. Follow up chest X-ray and chest computer tomography show resolved bilateral diffuse infiltration in both lower lung fields after oseltamivir treatment.

Reference

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