51 Cases Of Fungal Infection In Patients With Systemic Lupus Erythcmatosus.

Objective To investigate the major predisposing factor, clinical features, diagnosis, antifungal therapy and prognosis of fungal infection (FI) in patients with systemic lupus erythcmatosus(SLE).Methods 51 cases of fungal infection in patients SLE admitted in the PUMC hospital from 2000 to 2005 were reviewed retrospectively. Results FI was found in 3.5%(51/1466) patients . The predisposing factor for FI included use of steroids/immunosuppressant/broad spectrum antibiotics over a long period, invasive manipulation and leucopenia. Candida albicans was ranked the first pathogen, thereafter were neoformans and Aspergillus species. The infective site were lung, oral cavity, cerebral meninges and blood etc. All the clinical manifestations of FI in SLE were not specific, included fever(90.2%),leucocytosis (11.8%).It was difficult to differentiate fungal infection with bacterial infection and SLE disease involved in lung. In antifungal drugs, fluconazole was used alone in 21 patients, amphotericin B in 7 patients, flucytosine in 4 patients, other patients used them in combination. Out of 51 patients, 26 were cured, 12 made improvement.The overall mortality was 19.6%( 10/51). Mortality in Aspergillus species infection was 80%(4/5). Hypoalbuminemia, hypoxia, Aspergillus species infection, and more than two infectious site might be the risk factors for mortality.Conclusion The incidence of fungal infection is increasing in recently years ,which is correlated with use of high dose steroid/immunosuppressant/ broad-spectrum antibiotics over a long period, invasive manipulation and...