Department of Surgery, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia.
Department of Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia.
Med Arch. 2022 Oct;76(5):391-394. doi: 10.5455/medarh.2022.76.391-394.
Systemic lupus erythematosus is a multisystemic autoimmune disorder that can present in many different ways that can be debilitating for many patients. These patients are at risk for developing infections following the introduction of immunosuppressive therapy. Breast infections, particularly of the fungal type, in nonlactating patients who are not in an immunosuppressive state are extremely rare.
We report a case of recurrent right breast fungal infections manifesting in the form of multiple abscesses in a systemic lupus erythematosus patient.
A 39 years old female patient presented with recurrent fungal breast abscesses. She was diagnosed with systemic lupus erythematosus nine years ago and was in remission being maintained with an antimalarial agent without the use of immunosuppressive therapy. Fluconazole was started for her prior to her visit to us, and she had no active complaints. She was not breastfeeding nor pregnant currently nor during any of the previous episodes. Examination was unremarkable, however cultures of samples from her previous lesions demonstrated growth of Candida albicans. A decision to manage her conservatively with the continuation of her antifungal therapy was made.
Lactation and breastfeeding are well-known risk factors for infectious mastitis and there is sparse literature regarding this condition in the absence of these risk factors. Studies evaluating other risk factors, particularly systemic lupus erythematosus, need to be conducted to determine any relationship and how to best manage this condition in such patients.
系统性红斑狼疮是一种多系统自身免疫性疾病，可表现出多种不同的症状，使许多患者身体虚弱。这些患者在接受免疫抑制治疗后易发生感染。在非哺乳期且未处于免疫抑制状态的非产褥期患者中，发生乳房感染（尤其是真菌感染）的情况极其罕见。
我们报告一例系统性红斑狼疮患者出现复发性右侧乳房真菌感染，表现为多个脓肿。
一名 39 岁女性患者出现复发性真菌性乳房脓肿。她九年前被诊断为系统性红斑狼疮，目前处于缓解期，仅使用抗疟药物维持治疗，未使用免疫抑制剂。在来我们这里就诊之前，她已开始服用氟康唑，但目前没有任何不适。她目前未哺乳、未妊娠，且既往各次发作时也无哺乳或妊娠。体格检查未见明显异常，但既往病变部位的培养标本显示出白色念珠菌生长。决定继续进行抗真菌治疗，对其进行保守治疗。
哺乳期和哺乳是感染性乳腺炎的已知危险因素，但对于无这些危险因素的情况下的这种疾病，相关文献很少。需要开展评估其他危险因素（尤其是系统性红斑狼疮）的研究，以确定这种疾病与这些危险因素之间的关系，以及如何在这类患者中最佳管理这种疾病。
