title: Sometimes There Is More Than One Puzzle on the Table: Pneumococcal Bacteremia as a New Systemic Lupus Erythematosus Presentation.
abstract: Infection is common and a leading cause of death in patients with systemic lupus erythematosus (SLE). SLE is associated with a diverse spectrum of immune impairments including humoral defects and hypocomplementemia that contribute to a lupus patient's increased susceptibility to infection with encapsulated bacteria. Nonetheless, there are only few reports of severe invasive bacterial infection as the initial presentation of SLE in the literature. Here, we report a rare case of SLE presenting with pneumococcal bacteremia. Based on the high resolution chest computed tomography and the result of blood cultures, the bacteremia was assumed to be secondary to pneumococcal pneumonia.
authors.affiliation: Department of Infectious Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 91388-13944, Iran.
authors.forename: Fereshte
authors.initials: F
authors.lastname: Sheybani
authors.affiliation: Department of Infectious Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 91388-13944, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Naderi
authors.affiliation: Department of Rheumatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 91388-13944, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Mirfeizi
authors.affiliation: Department of Infectious Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 91388-13944, Iran.
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Erfani