The role of infections in neuropsychiatric lupus

Lupus. 2017 Apr;26(5):490-496. doi: 10.1177/0961203317691375.


Opportunistic infections can cause manifestations that resemble neuropsychiatric systemic lupus erythematosus and they can also trigger lupus flares. Therefore, central nervous system infections as differential diagnosis in neuropsychiatric systemic lupus erythematosus may be difficult, leading to delayed diagnosis and specific treatment. Central nervous system infection in systemic lupus erythematosus is not common but, if left misdiagnosed and not treated promptly, can be fatal. Complementary diagnosis tests are generally non-specific and disappointing. Caution with immunosuppressive drug treatment should be emphasized while an opportunistic infection cannot be ruled out. In this review, we discuss the various types of central nervous system infections reported in systemic lupus erythematosus patients, highlighting the importance of their early recognition in order to improve morbidity and mortality. Prevention with vaccination is a recommended approach.

Keywords: Systemic lupus erythematosus; infection; neuropsychiatric lupus; pathogenesis; vaccination.

Publication types

  • Review

MeSH terms

  • Central Nervous System Diseases / microbiology*
  • Diagnosis, Differential
  • Early Diagnosis
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / drug therapy*
  • Lupus Vasculitis, Central Nervous System / diagnosis*
  • Male
  • Opportunistic Infections / complications
  • Opportunistic Infections / diagnosis*
  • Symptom Flare Up


  • Immunosuppressive Agents