Invasive fungal infections in systemic lupus erythematosus: 10-year experience in a teaching hospital in Taiwan

Infections are an important issue in systemic lupus erythematosus (SLE) patients and account for 30-50% of mortality and morbidity [1-5]. Both cellular and humoral immunity defects [6] and the use of corticosteroids and immunosuppressant agents [7,8] make these patients more susceptible to pathogens. Most infectious processes result from common microorganisms such as bacteria and viruses [9]. Invasive fungal infections are rare in SLE patients with a variable incidence rate [3,10] and include different dominant species [11,12], but always leading to a poor outcome. Clinical suspicion for fungal infections should be emphasized in lupus patients with fever of unknown origin and atypical clinical manifestation [13,14]. However, the diagnosis of invasive fungal infections in this group is often difficult in clinical practice; therefore, treatment is usually delayed, and the mortality rate is quite high. In this study, we analyze clinical characteristics and laboratory data in SLE patients with invasive fungal infections in a tertiary single center over a ten-year period. The study is designed to investigate possible risk factors and outcome of invasive fungal infections in SLE patients. Invasive fungal infections in systemic lupus erythematosus: 10-year experience in a teaching hospital in Taiwan Wei-I Tsai, Chien-Sheng Wu, Ping-Ning Hsu Division of Rheumatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Division of Rheumatology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei County, Taiwan Graduate Institute of Immunology, College of Medicine, National Taiwan University, Taipei, Taiwan