Invasive fungal infections in patients with systemic lupus erythematosus.
OBJECTIVE
Invasive fungal infections (IFI) are catastrophic diseases associated with a high mortality. Relatively few cases of IFI have been described in systemic lupus erythematosus (SLE) and their related factors have not been completely explored. We evaluated factors associated with IFI in patients with SLE.


METHODS
All patients with both IFI and SLE admitted to our hospital in the last 7 years were evaluated and each was compared with 5 hospitalized patients with SLE (controls). Demographic factors, duration of SLE, and treatment in the previous month were compared.


RESULTS
Sixty patients with SLE were evaluated (10 with IFI and 50 controls). Median age was 29 years. High C-reactive protein levels were associated with IFI, along with other factors such as high disease activity, mechanical ventilation, treatment with antibiotics, hemodialysis, high doses of glucocorticoids (GC), and treatment with mycophenolate mofetil. Mortality was 4 times more frequent in patients with IFI than in SLE patients without the deep fungal infection.


CONCLUSIONS
IFI is a rare infection observed in patients with rheumatic diseases. We describe factors associated with IFI in patients with SLE. IFI is associated with elevated morbidity and mortality. Early diagnosis and treatment are desirable.
Regional Unit of Rheumatology and Osteoporosis, Central Hospital Dr. Ignacio Morones Prieto, and Faculty of Medicine, Universidad Autónoma de San Luis Potosí, Av. V. Carranza 2395, San Luis Potosí, S.L.P., Mexico, 78240.
Marco Ulises
MU
Martínez-Martínez
David
D
Herrera-Van Oostdam
Susana
S
Román-Acosta
Martín
M
Magaña-Aquino
Lourdes
L
Baranda-Cándido
Carlos
C
Abud-Mendoza
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002097:C-Reactive Protein; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D012307:Risk Factors; D012720:Severity of Illness Index
D000935:Antifungal Agents; D005938:Glucocorticoids; D002097:C-Reactive Protein