Invasive fungal disease in patients with systemic lupus erythematosus from Southern China: a retrospective study

Abstract

Objective To investigate the characteristics and associated factors of invasive fungal disease in patients with systemic lupus erythematosus from Southern China. Methods A retrospective study was performed. Demographic and clinical characteristics, laboratory data, and radiographic manifestations were recorded. Results A total of 45 lupus patients with invasive fungal disease (incidence 1.1%) were included. Twenty-three cases (51.1%) were infected with mold and 22 cases (48.9%) with yeast. Aspergillus spp. (44.4%) and Cryptococcus spp. (33.3%) were common. Aspergillosis mainly occurred in the lung. Cryptococcosis developed in the lung (40.0%), meninges (46.7%) and bloodstream (13.3%). Compared with yeast infection, mold infection tended to develop in patients with active lupus nephritis (65.2% vs. 31.8%, P = 0.03) and the mortality rate was higher (20.0% vs. 0%, P = 0.001). Co-infection with bacteria, virus or superficial fungi occurred in 12 patients (26.7%). Multivariate logistic regression analysis indicated that lymphopenia (odds ratio 2.65, 95% confidential interval 1.14–6.20, P = 0.02) and an accumulated dose of glucocorticoid (odds ratio 1.58, 95% confidence interval 1.10–2.25, P = 0.01) was associated with invasive fungal disease in lupus patients. Conclusion Mold infection tended to develop in patients with active lupus disease with high mortality. Co-infection is not rare. Lymphopenia and an accumulated dose of glucocorticoid are associated with invasive fungal disease in lupus patients.

Analysis on the pathogenic fungi in patients with superficial mycosis in the Northeastern China during 10 years

“…Superficial mycosis, commonly known as ringworm, is a common infectious disease in dermatology caused by pathogenic fungi parasitic on keratin tissue (1,2). Its incidence rate is increasing year by year (3). In recent years, with the wide application of broad-spectrum antibiotics, glucocorticoids, immunosuppressants and anti-tumor drugs, the possibility of secondary fungal infection in patients has increased.…”

Invasive mycoses in patients with connective tissue disease from Southern China: clinical features and associated factors

“…In our research, the incidence of IM was the highest in AAV (1.5%), compared to 0.5% in the SLE population [22]. Charles et al reviewed 80 patients with AAV treated with rituximab and found three cases of aspergillosis (3.8%) [23].…”

Infective patterns of cryptococcosis in patients with connective tissue disease:a retrospective study

“…Our results further supported the previous finding and showed that accumulated dose of GC was associated with the development of cryptococcosis in patients with CTD. Other risk factors such as lymphopenia, hypoalbuminemia which were associated with aspergillosis [27] seemed to be less relevant in cryptococcosis.…”