Disseminated histoplasmosis in systemic lupus erythematosus: case report and review of the literature.


Journal Article (Review)

OBJECTIVES: To report a patient who developed both central nervous system systemic lupus erythematosus (SLE) and disseminated histoplasmosis and to review the literature regarding histoplasma infection in patients with SLE. METHODS: MEDLINE review of the medical literature published in English. RESULTS: Disseminated histoplasmosis occurs rarely in patients with SLE. The main risk factor is treatment with corticosteroids at doses of 20 mg/d or greater. Fever, dyspnea, pleurisy, and weight loss are typical presenting symptoms. The most commonly involved tissues are lung, liver, and bone marrow. In our patient, both SLE flare and disseminated histoplasmosis were present simultaneously. CONCLUSIONS: Opportunistic infection is an important complication of SLE and may be difficult to diagnose. Symptoms of infection may mimic those of a lupus flare, or conversely, symptoms may be masked by the use of corticosteroids. Fever, unexplained tissue involvement, atypical clinical patterns, and poor response to immunosuppressive therapy should alert the clinician to aggressively pursue evaluation of possible infection in patients with SLE.

Full Text

Duke Authors

Cited Authors

  • Hansen, KE; St Clair, EW

Published Date

  • December 1998

Published In

Volume / Issue

  • 28 / 3

Start / End Page

  • 193 - 199

PubMed ID

  • 9872480

Pubmed Central ID

  • 9872480

Electronic International Standard Serial Number (EISSN)

  • 1532-866X

International Standard Serial Number (ISSN)

  • 0049-0172

Digital Object Identifier (DOI)

  • 10.1016/s0049-0172(98)80036-x


  • eng