Brain abscess caused by Micrococcus luteus in a patient with systemic lupus erythematosus: case-based review

Rheumatol Int. 2018 Dec;38(12):2323-2328. doi: 10.1007/s00296-018-4182-2. Epub 2018 Oct 29.

Abstract

Central nervous system infections, which are rarely seen in systemic lupus erythematosus (SLE), have considerably high mortality but they are difficult to distinguish from neuropsychiatric manifestation of lupus. This article reports the case of a patient with SLE with brain abscess which developed during immunosuppressive therapy for lupus nephritis. The patient completely recovered without neurological sequelae by open surgical drainage and 12-week antibiotic therapy. It is recommended that CNS infections must be excluded in patients with SLE, particularly who are receiving immunosuppressive therapy.

Keywords: Brain abscess; Central nervous system infections; Micrococcus luteus; Systemic lupus erythematosus.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Bacteriological Techniques
  • Brain Abscess / diagnosis
  • Brain Abscess / immunology
  • Brain Abscess / microbiology*
  • Brain Abscess / therapy
  • Central Nervous System Bacterial Infections / diagnosis
  • Central Nervous System Bacterial Infections / immunology
  • Central Nervous System Bacterial Infections / microbiology*
  • Central Nervous System Bacterial Infections / therapy
  • Diagnosis, Differential
  • Drainage
  • Female
  • Gram-Positive Bacterial Infections / diagnosis
  • Gram-Positive Bacterial Infections / immunology
  • Gram-Positive Bacterial Infections / microbiology*
  • Gram-Positive Bacterial Infections / therapy
  • Humans
  • Immunocompromised Host*
  • Immunosuppressive Agents / adverse effects*
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / drug therapy*
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Nephritis / diagnosis
  • Lupus Nephritis / drug therapy*
  • Lupus Nephritis / immunology
  • Lupus Vasculitis, Central Nervous System / diagnosis
  • Lupus Vasculitis, Central Nervous System / immunology
  • Magnetic Resonance Imaging
  • Micrococcus luteus / drug effects
  • Micrococcus luteus / immunology
  • Micrococcus luteus / isolation & purification*
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / immunology
  • Opportunistic Infections / microbiology*
  • Opportunistic Infections / therapy
  • Predictive Value of Tests
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Immunosuppressive Agents