Lupus Site - a guide for lupus patients and their families

Patients with lupus are more susceptible to infections because they have altered immune systems, and also because many patients are on treatment (steroids & cytotoxics) that suppresses immune system function, leaving them more prone to infection.

Lupus patients who get infections frequently show worse clinical signs, & require longer treatment than non-lupus patients.

The most common bacterial infections seen in lupus affect the respiratory tract and the urinary tract. Septic arthritis, tuberculosis, salmonella, cold viruses, & shingles are also more common. The most common fungal infection seen in lupus is candida (thrush).

It is important to distinguish between a lupus flare and an infection. Fever and decreased energy are symptoms that are associated with both infections and lupus flares. Any lupus patient who exhibits symptoms that could be an infection or flare should contact her physician. Blood tests such as a white cell count can help to distinguish a flare from an infection.

Patients at high risk of infection should probably take antibiotics before surgical or dental procedures.

Lupus patients should try to minimise their exposure to people who have colds, 'flu, and other infections, although this is easier said than done!

Lupus patients should probably avoid the antibiotics penicillin and septrin (sulfa), as they may exacerbate lupus, and many lupus patients are allergic to them.

It has been previously thought that lupus patients should avoid immunisations because they could exacerbate lupus. However, the vaccine for influenza has now been shown to be safe and effective; the pneumococcal vaccine is also safe, but resultant antibody levels are somewhat lower in patients with SLE. It is not advisable for patients receiving steroids or cytotoxic therapy to have live vaccines, because these drugs cause immune suppression that may promote infection.

Some patients who receive allergy shots (immunotherapy) will have a flare following this treatment. In 1989, the World Health Organisation recommended that patients with autoimmune diseases should not receive allergy shots. Lupus patients should always consult their rheumatologist before receiving immunotherapy.