Mok C C, Lau C S, Yuen K Y
Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong.
Clin Exp Rheumatol. 1998 Mar-Apr;16(2):169-71.
Cryptococcal meningitis is a rare but well recognized complication of systemic lupus erythematosus (SLE). Since in all previously reported cases in the medical literature the patients developed this opportunistic infection as the result of immunosuppressive therapies, whether the intrinsic immunological abnormalities of SLE per se contribute to the susceptibility remains controversial. We report on a patient who presented concurrently with cryptococcal meningitis and cryptococcaemia at the time of her diagnosis of active SLE. This highlights the possibility that intrinsic immunological defects of SLE may be directly responsible for the predisposition to fungal infections. In addition, when SLE patients present with neurological symptoms, the possible presence of central nervous system (CNS) infection must be checked for, even if immunosuppressive treatment is not being considered.
隐球菌性脑膜炎是系统性红斑狼疮（SLE）一种罕见但已被充分认识的并发症。由于在医学文献中所有先前报道的病例中，患者都是因免疫抑制治疗而发生这种机会性感染，所以SLE本身内在的免疫异常是否导致易感性仍存在争议。我们报告了一名在诊断为活动性SLE时同时出现隐球菌性脑膜炎和隐球菌血症的患者。这凸显了SLE内在免疫缺陷可能直接导致易患真菌感染的可能性。此外，当SLE患者出现神经症状时，即使不考虑免疫抑制治疗，也必须检查是否可能存在中枢神经系统（CNS）感染。
