[Spontaneous septic arthritis in disseminated lupus erythematosus]

The authors report the case of a young 17 year-old girl with acute systemic lupus erythematosus who presented with purulent arthritis due to Group A hemolytic streptococcus in the knee, and perhaps other joints. She had not yet received any treatment. The purulent arthritis was cured by antibiotics. In spite of corticosteroids and immuno-suppressive agents (Chlorambucil), the patient died one year later. Spontaneous purulent arthritis is rare during systemic lupus erythematosus. We found only 8 other cases in the world literature. Contrary to our case, these were patients already treated with corticosteroid or immuno-suppressive agents. In our patient, the absence of previous treatment permitted us to incriminate the lupus itself in the onset of this infection. The conditions of onset of infection during lupus erythematosus are discussed.