Perić-Popadić Aleksandra, Bogić Mirjana, Tomić-Spirić Vesna, Djurić Vojislav, Bolpacić Jasna, Milosević Branko, Spasić Sanja, Rasković Sanvila
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Vojnosanit Pregl. 2013 Jul;70(7):688-92. doi: 10.2298/vsp1307690p.
Infections in patients with systemic lupus erythematosus (SLE) are a significant factor of morbidity and mortality. Although central nervous system infections, including septic meningitis, are rare in patients with SLE, they can be significant causes of mortality inspite of the prompt and accurate diagnosis and proper management.
We presented a woman with the diagnosis of SLE and diffuse proliferative lupus nephritis. Because of disease activity we introduced cytostatic immunosuppressive therapy, cyclophosphamide and then azathioprine. Meningoencephalitis, staphylococcal sepsis and abscess of the brain, with resulting seizures developed.
This case alerts to the need of careful examination of patients with SLE, collection of adequate cultures and evaluation of predisposition towards infections, before the introduction of immunosuppressants due to potentially fatal infection.
系统性红斑狼疮（SLE）患者的感染是发病和死亡的重要因素。尽管包括化脓性脑膜炎在内的中枢神经系统感染在SLE患者中较为罕见，但尽管诊断迅速准确且管理得当，它们仍可能是导致死亡的重要原因。
我们报告了一名诊断为SLE和弥漫性增殖性狼疮性肾炎的女性。由于疾病活动，我们采用了细胞毒性免疫抑制疗法，即环磷酰胺，然后是硫唑嘌呤。随后发生了脑膜脑炎、葡萄球菌败血症和脑脓肿，并导致癫痫发作。
该病例提醒我们，在因潜在致命感染而使用免疫抑制剂之前，需要对SLE患者进行仔细检查，采集足够的培养物并评估感染易感性。
