Disseminated histoplasmosis in systemic lupus erythematosus: case report and review of the literature.
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.
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Related Subject Headings
- Opportunistic Infections
- Middle Aged
- Lupus Erythematosus, Systemic
- Humans
- Histoplasmosis
- Female
- Arthritis & Rheumatology
- 3202 Clinical sciences
- 1117 Public Health and Health Services
- 1103 Clinical Sciences
Citation
Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Opportunistic Infections
- Middle Aged
- Lupus Erythematosus, Systemic
- Humans
- Histoplasmosis
- Female
- Arthritis & Rheumatology
- 3202 Clinical sciences
- 1117 Public Health and Health Services
- 1103 Clinical Sciences