The Journal of the Korean Rheumatism Association  1999;6(3):253-259

Two Cases of Aspergillosis in Systemic Lupus Erythematosus.

Hyun Su KIM 1 ; Yeon Sik HONG ; Sang Su PAE ; Wan Uk KIM ; Jun Ki MIN ; Sang Heon LEE ; Seong Whan PARK ; Chul Soo CHO ; Ho Youn KIM

Affiliations

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Keywords

Systemic lupus erythematosus; Aspergillosis

Country

Republic of Korea

Language

Korean

Abstract

Invasive infections with Aspergillus species may occur in patients with severe immune deficits and have been described rarely in systemic lupus erythematosus. We present two cases of pulmonary aspergillosis in steroid-treated systemic lupus erythematosus(SLE). Both patients had active SLE treated with high dose corticosteroids and prescribed with broad spectrum antibiotics. One patient had combined infection with pulmonary tuberculosis and the other present granulocytopenia. The diagnosis was delayed because symptoms and radiologic findings were confused with lupus pneumonitis and bacterial infections. This was similar to those reported previously. Diagnosis was confirmed by identification of the typical septated hyphae within tissue. We prescribed high dose amphotericin B to both patients. But one died with sepsis. Aspergillosis should be suspected in patients with active SLE who are immunocompromised and sustain concomitant bacterial infections. More aggressive diagnostic investigation and treatment may be needed to improve poor prognosis.