<i>Salmonella</i> bacteremia in systemic lupus erythematosus. Eight‐year experience at a municipal hospital

Abramson, Steven B.; Kramer, Sara B.; Radin, Allen; Holzman, Robert S.

doi:10.1002/art.1780280112

Cited by 79 publications

(27 citation statements)

References 22 publications

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“…All patients with autoimmune diseases received corticosteroid treatment as well. Therefore autoimmune diseases by themselves may not be the direct risk factors for non-typhoidal Salmonella bacteraemia, although there was a report (Li et al 1993) of Salmonella bacteraemia in an SLE patient without immunosuppressive therapy, but corticosteroid therapy would more likely be the cause of the defect in cell mediated immunity that led to Salmonella infections in SLE patients (Abramson et al 1985). AIDS and corticosteroid use are very important risk factors for non-typhoidal Salmonella bacteraemia in the Thai population.…”

Section: Resultsmentioning

confidence: 99%

Non‐typhoidal Salmonella bacteraemia: clinical features and risk factors

Thamlikitkul

Dhiraputra

Paisarnsinsup

et al. 1996

Tropical Med Int Health

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SummaryA case control study was conducted to determine the risk factors of non-typhoidal Salmonella bacteraemia. Eighty adult patients with non-typhoidal Salmonella bacteraemia admitted to Siriraj Hospital from January to December 1993 served as the cases. The controls comprised 3 groups: group I , 80 adult in-patients with Escherichia coli bacteraemia; group 2, 80 adult in-patients who did not have bacteraemia and had been admitted to the hospital during the same period as the cases; group 3, 80 in-patients who did not have Salmonella bacteraemia and matched the cases in terms of gender, age, hospital services and admission date. AIDS and corticosteroid use were the major risk factors for acquiring non-typhoidal Salmonella bacteraemia with an odds ratio of 7.27 to 12.31 (95% confidence interval of 3.39 to 29.40). Almost all patients with non-typhoidal Salmonella bacteraemia presented with a fever for a median duration of 7 days. AIDS patients usually had concomitant opportunistic infections. Salmonella group D was the most common serogroup. Most patients were treated with co-trimoxazole, quinolones, ceftriaxone and ampicillin. Localized suppurative complications were observed in 14% of the patients; the overall mortality rate was 36.3%, 12% of whom died prior to receiving appropriate antibiotics for Salmonella.keywords non-typhoidal Salmonella bacteraemia

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Section: Resultsmentioning

confidence: 99%

Non‐typhoidal Salmonella bacteraemia: clinical features and risk factors

Thamlikitkul

Dhiraputra

Paisarnsinsup

et al. 1996

Tropical Med Int Health

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“…[66][67][68][69] In fact, SLE is the most frequent underlying disease in patients who present with Salmonella bacteremia. 66,67 Mycobacterial infections, mainly M. tuberculosis are of major concern in SLE patients who live in developing countries. In this study 5.5% SLE patient developed tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Lupus Around the World

Al-Rayes

Al-Swailem

Arfin

et al. 2007

Lupus

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This study demonstrates demographic, clinical and laboratory characteristics with special reference to infections in Saudi patients with SLE. One-hundred and ninety-nine patients with SLE treated at Riyadh Armed Forces Hospital, Saudi Arabia over a period of 15 years (1990-2005) were retrospectively reviewed. There were 162 females and 37 males (4.4 : 1) with an average age of 35 years at onset of disease. Duration of diseases ranged from one to 23 years with a mean of 7.23 years. Some of the clinical characteristics of SLE patients observed were nephritis (53.7%), fever (53.26%), neuropsychological disorder (36.18%), malar/butterfly rash (27.6%), pulmonary disorder (22.6%), photosensitivity (21.6%), cardiac involvement (21.1%) and oral ulcers (19.09%). Infection was the major complication with 58.79% of SLE patient having suffered from various infections. A total of 22 species of pathogens including gram positive and gram negative bacteria, viruses and fungi were isolated from 117 SLE patients. Single to multiple episode of infection with various pathogens were recorded however, majority of patients harboured one or two species of pathogens. Bacterial infection was predominant (78.6%) followed by viral (28.2%) and fungal (28.2%) infections. Forty-four percent of SLE patients were found to be infected with organisms classified as opportunistic. The high incidence of infections in SLE patients may be attributed to the multiple intrinsic and extrinsic risk factors including deficiency of complement (C3 and C4), disease activity, renal impairment, use of glucocorticoid and cytotoxic drugs. It is concluded that more judicious use of corticosteroids and other immunosuppressive agents will be critical to limit the infections in SLE and a high alert and close monitoring of patients will ensure optimal patient outcome, both in terms of morbidity and mortality.

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“…It may be an uncommon pathogen for osteomyelitis and septic arthritis in the general population, but it is the most common bacterial infection in SLE patients. [32][33][34][35] Several clinical risk factors of salmonellosis have been described, including lupus nephritis, older age, functional hypo-splenism, avascular necrosis of the femoral head, and other concomitant infections. 9,10,32 However, it remains unclear if the high susceptibility to Salmonella is due to impaired functioning of PMNs.…”

Section: Discussionmentioning

confidence: 99%