title: The role of infections in neuropsychiatric lupus.
abstract: Opportunistic infections can cause manifestations that resemble neuropsychiatric systemic lupus erythematosus and they can also trigger lupus flares. Therefore, central nervous system infections as differential diagnosis in neuropsychiatric systemic lupus erythematosus may be difficult, leading to delayed diagnosis and specific treatment. Central nervous system infection in systemic lupus erythematosus is not common but, if left misdiagnosed and not treated promptly, can be fatal. Complementary diagnosis tests are generally non-specific and disappointing. Caution with immunosuppressive drug treatment should be emphasized while an opportunistic infection cannot be ruled out. In this review, we discuss the various types of central nervous system infections reported in systemic lupus erythematosus patients, highlighting the importance of their early recognition in order to improve morbidity and mortality. Prevention with vaccination is a recommended approach.
authors.affiliation: 1 Rheumatology Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: F M
authors.initials: FM
authors.lastname: Ribeiro
authors.affiliation: 2 Internal Medicine Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.|3 Internal Medicine Department, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: F
authors.initials: F
authors.lastname: Signorelli
mesh_terms: D002493:Central Nervous System Diseases / Q000382:microbiology*; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy*; D020945:Lupus Vasculitis, Central Nervous System / Q000175:diagnosis*; D008297:Male; D009894:Opportunistic Infections / Q000150:complications / Q000175:diagnosis*; D000067251:Symptom Flare Up
chemical_list: D007166:Immunosuppressive Agents
keywords: Systemic lupus erythematosus; infection; neuropsychiatric lupus; pathogenesis; vaccination