Bushra Jamil, Sobia Rafi, Hammad Hussain, Kamran Hameed.
Spectrum and outcome of infections in Systemic Lupus Erythematosus patients.
J Coll Physicians Surg Pak Jan ;16(9):625-6.

All patients fulfilling the diagnostic criteria of systemic lupus erythematosus were included in this observational study. Over a period of 10 years, 80 admissions (23.8%) were for management of 96 episodes of infections in 69 patients. Bacterial infections accounted for more than 50% of all infectious episodes. Staphylococcus (S.) aureus was the commonest organism isolated, followed by Escherichia coli and Klebsiella spp. Four patients developed tuberculosis while receiving 10-30 mg/day of prednisolone; one had also received pulse therapy with methylprednisolone 3 months before developing TB. Sepsis due to Candida albicans (3) and Aspergillus flavus (1) was seen in patients receiving 40-60 mg/day of prednisolone. The white blood cell count (WBC) was recorded for 12 patients out of 14 who were not on immunosuppressive therapy within three months of development of infection. The mean WBC count before admission was 6005/mm3, SD + 1747. Fourteen patients had leucopenia on admission (total white cell count <4000/mm3). The ESR was recorded only for 8 patients within the three months prior to admission. A significant difference was found in mean ESR before (30 mm/hr SD + 13.0) and at the onset of infection in patients when the value was available for comparison (91.13, SD + 40.25, mean difference 54.88, C.I. 21.21-88.54, p-value: 0.006). In 55 out of 80 admissions (68.75%), patients were on steroid (oral prednisolone) therapy. The mean duration of steroid use was 3.38 months (SD + 2.23). The maximum number of admissions for infections was seen in patients taking steroids for less than 6 months, 33/80 (41.25 %).

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