Criptococose Disseminada em Lúpus Eritematoso Sistêmico Juvenil Disseminated Cryptococcosis in Juvenile Systemic Erythematosus Lupus
2008
ABSTRACT Systemic lupus erythematosus (SLE) is a multisystem inflam-matory disease, in which infection is responsible for high rates of mortality. The use of corticosteroids and immunosuppressive therapy contributes to this high incidence of infections. Although bacteria are the most common agents, a wide variety of pathogens has been reported. This article reports a case of SLE in a 15 years-old boy with disseminated criptococosis (central nervous system, lungs and kidneys) and presumptive tuberculous encephalitis. The coexistence of infection by Cryptococcus and SLE is described in the literature, but the combination of this with tuberculous encephalitis is uncommon. The potential risk of infection in im-munosuppressed SLE patients should alert the physician to adopt early diagnostic and therapeutic strategies aiming at an extended spectrum of pathogens. Keywords: systemic lupus erythematosus, disseminated crypto-coccosis, tuberculous encephalitis. RESUMO O lupus eritematoso sistemico (LES) e uma doenca inflamatoria multissistemica, na qual as infeccoes sao responsaveis por altos indices de morbimortalidade. Os usos de corticoide e imunos-supressores contribuem para o aumento das infeccoes. Embora as bacterias sejam os agentes mais comuns, grande variedade de patogenos tem sido relatada. Este artigo descreve um caso de LES em um menino de 15 anos com criptococose disseminada (sistema nervoso central, pulmao e rim) e encefalite tuberculosa presumivel. A coexistencia de infeccao por
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