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Systemic Lupus Erythematosus With Multi-System Involvement and Immunosuppression Presenting With a Rare Fungal Brain

Jenna Sutton1, Elliot Runge2, Ryan Shao1

  • 1Internal Medicine, University of Nevada Las Vegas School of Medicine, Las Vegas, USA.

Cureus
|August 18, 2023
PubMed

Insights

A rare brain abscess caused by Scedosporium apiospermum occurred in a patient with systemic lupus erythematosus (SLE). This case highlights the risk of fungal infections in immunocompromised individuals.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Neurology

Background:

  • Scedosporium apiospermum is an opportunistic fungal pathogen prevalent in soil and water.
  • Individuals with compromised immune systems, particularly those with systemic autoimmune diseases like systemic lupus erythematosus (SLE), are susceptible to severe infections.
  • Immunosuppressive therapies used to manage SLE can further increase infection risk.

Observation:

  • A patient with refractory multi-organ systemic lupus erythematosus (SLE) on steroid therapy presented with new-onset neurologic deficits.
  • Diagnostic investigations revealed a brain abscess as the cause of the neurological symptoms.

Findings:

  • The brain abscess was attributed to a rare fungal etiology, specifically Scedosporium apiospermum.
  • This represents a unique and challenging clinical presentation.

Implications:

  • This case underscores the importance of considering rare fungal infections in immunocompromised patients, especially those with SLE.
  • Early diagnosis and appropriate antifungal treatment are crucial for managing Scedosporium apiospermum brain abscesses.
  • Further research into the pathogenesis and treatment of fungal brain infections in SLE patients is warranted.
Keywords:
cns infectioncrainectomydisseminated fungal infectionfungal brain abscessid critical carerheumatologyscedosporium apiospermumsystemic lupus erythromatosus

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