Coexisting Pneumocystis carinii pneumonia, cytomegalovirus pneumonitis and salmonellosis in systemic lupus erythematosus

Article Abstract:

Opportunistic infections such as pneumocystis carinii pneumonia occur in patients whose immune systems are compromised by diseases such as AIDS or by steroids or other therapies. Some opportunistic infections, such as cytomegalovirus and salmonella, may coexist. A case is described of a 23-year-old woman with systemic lupus erythematosus who developed three opportunistic infections while being treated with steroids and cyclophosphamide. She developed hip pain which was due to necrosis (cell death) of the head of the femur (thigh bone). Fever was also present, and after salmonella bacteria was identified in the blood, the patient was treated with antibiotics. However, the fever recurred, and a cavity was found in the lungs. Tuberculosis was suspected, but treatment was not helpful, and further X-rays showed solid areas of infiltration. Analysis of lung tissue revealed Pneumocystis carinii pneumonia and cytomegalovirus. Further antibiotics were administered and the patient's steroid dose was reduced. She subsequently improved. The coexistence of these three infections in patients with systemic lupus erythematosus has not previously been reported, although significant infections occur in patients with this disease. An assertive diagnostic approach is important when evaluating lung problems in patients with lupus, so that early and appropriate antibiotic treatment may be initiated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Pneumocystis carinii pneumonia, Cytomegalovirus infections, Salmonellosis, Opportunistic infections

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Pneumococcal septicaemia in a patient with systemic lupus erythematosus

Article Abstract:

Patients with systemic lupus erythematosus (SLE) may be at increased risk for a condition characterized by diminished spleen function called hyposplenism that can possibly lead to blood poisoning. Medical characteristics and treatment details of a 38-year-old patient with SLE who developed hyposplenism and blood poisoning are presented. Hyposplenism was confirmed by ultrasound scan and blood tests showing nucleus remnants called Howell-Jolly bodies. The blood infection was treated with oxygen and antibiotics. Two months before hospitalization there was no evidence of active SLE disease or infection.

Abnormalities, Risk factors, Spleen, Septicemia

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