Naceur Ines, Skhiri Sahar, Ben Achour Tayssir, Said Fatma, Smiti Monia, Ben Ghorbel Imed, Houman Mohamed Habib
Department of Internal Medicine , La Rabta Hospital, Faculty of Medicine of Tunis , University of Tunis El Manar, Tunis, Tunisia.
Tunis Med. 2023 Nov 5;101(11):821-825.
To describe characteristics of systemic lupus erythematosus (SLE) patients with infectious complications and to determine frequency, clinical and microbiological features and outcomes of reported infections.
This is a descriptive, retrospective study conducted over an 11-year period at the Internal Medicine Department La Rabta Hospital Tunis, collecting medical records of SLE patients who had experienced infectious complications.
Fifty-six patients were included, consisting of 52 females and 4 males (gender ratio M/F= 0.07). The mean age at SLE diagnosis was 35±13.8 years. The mean duration of the disease was 4.8±3.1 years. A total of seventy-eight infections were documented. Infection revealed the disease in 12 patients (21%) and occurred after an average delay of 36 months [1-156 months] of SLE diagnosis. Forty-three patients (74%) were receiving corticosteroid therapy, associated in 37.5% of cases with immunosuppressive treatment. Urinary and pleuro-pulmonary infections were most common infectious sites. An infectious agent was identified in 59 cases (76%). Bacterial infections were the most common (76%), dominated by the enterobacteria pathogen agent. Viral infections (n=12) were mainly caused by varicella-zoster virus and cytomegalovirus. Five patients required intensive care. Twenty patients experienced a lupus flare during the infectious episode. The outcome was favorable in 52 (93%) patients. Three patients died, two due to septic shock caused by pulmonary infection in two cases and cutaneous infection in one patient. One patient died from a probable pulmonary embolism.
Infectious complications are responsible for significant morbidity and mortality during SLE. Hence the importance of early diagnosis and adequate management.
描述患有感染性并发症的系统性红斑狼疮（SLE）患者的特征，并确定报告感染的频率、临床和微生物学特征及结局。
这是一项在突尼斯拉巴塔医院内科进行的为期11年的描述性回顾性研究，收集了有感染性并发症的SLE患者的病历。
纳入56例患者，其中52例女性，4例男性（性别比M/F = 0.07）。SLE诊断时的平均年龄为35±13.8岁。疾病的平均病程为4.8±3.1年。共记录到78次感染。12例患者（21%）因感染确诊疾病，感染发生在SLE诊断平均延迟36个月[1 - 156个月]之后。43例患者（74%）正在接受皮质类固醇治疗，37.5%的病例联合免疫抑制治疗。泌尿系统和胸膜肺部感染是最常见的感染部位。59例（76%）确定了感染病原体。细菌感染最常见（76%），以肠道杆菌病原体为主。病毒感染（n = 12）主要由水痘 - 带状疱疹病毒和巨细胞病毒引起。5例患者需要重症监护。20例患者在感染发作期间出现狼疮病情加重。52例（93%）患者结局良好。3例患者死亡，2例因肺部感染导致感染性休克死亡，1例因皮肤感染死亡。1例患者可能死于肺栓塞。
感染性并发症是SLE发病和死亡的重要原因。因此早期诊断和适当管理非常重要。
