Lupus and Infections- An Overview

Introduction:

Lupus or systemic lupus erythematosus is a type of disease that causes inflammation in various parts of the body like skin, heart, lungs, blood, etc. It is a type of immune system disorder. Treatment can be done by managing the symptoms in the affected body part. People suffering from systemic lupus erythematosus are more susceptible to acquiring infections than others. Some of these infections are herpes zoster, staphylococcus aureus, etc.

What Is Lupus?

Lupus, also known as systemic lupus erythematosus, is a disease affecting the immune system. Therefore, the immune system attacks the body instead of protecting it from infections. Lupus results in inflammation in the entire body. The symptoms of this disease vary based on the body part under attack by the immune system. It can affect skin, blood, joints, kidneys, etc.

What Causes Lupus?

The exact causative factor is not known for what causes lupus. Studies reveal that certain factors regarding the health or the environment where a person resides trigger lupus, such as:

1. Genetic Factors: Certain genetic mutations might make people more susceptible to lupus.

2. Hormones: A few hormonal reactions in the body (especially estrogen) might make a person more susceptible to developing lupus.

3. Environmental Factors: Where a person resides and how much pollution or sunlight they get exposed to might affect the risk of catching lupus.

4. Health History: Smoking, stress level, and some other health conditions (like other autoimmune diseases) may act as triggering factors for lupus.

What Are the Types of Lupus?

1. Cutaneous Lupus Erythematous: This type of lupus affects the skin only.

2. Drug-Induced Lupus: Certain medications trigger factors for lupus symptoms as a side effect. It is generally short-term and might go away once the medication is stopped, which was responsible for causing it.

3. Neonatal lupus: Babies are sometimes born with lupus. Babies born to biological parents with lupus aren’t certain to have lupus, but they might have an increased risk.

What Are the Symptoms of Lupus?

Different people with Lupus experience different symptoms, but these are some of the most common. These symptoms might also come and go, hindering the daily routine. The most usual symptoms of lupus are:

• Joint pain, muscle pain, or chest pain (especially while taking a deep breath).

• Headaches.

• Rashes (rashes are commonly seen across the face; sometimes, it is called butterfly rash).

• Fever.

• Hair loss.

• Mouth sores.

• Fatigue (feeling of tiredness).

• Shortness of breath (dyspnea).

• Glands become swollen.

• Swelling in the arms, legs, or face also might occur.

• Confusion.

• Blood clots.

Sometimes Lupus can result in other health conditions or issues such as:

• Photosensitivity (sensitivity towards sunlight).

• Dry eye.

• Depression (or other mental health conditions).

• Seizures.

• Anemia.

• Raynaud’s syndrome.

• Osteoporosis.

• Heart disease.

• Kidney disease.

What Are Lupus and Infections?

People with lupus are susceptible to acquiring the same infections that affect others. However, they are also at risk of ‘opportunistic’ organisms, like fungi, which more easily cause infection when the immune system weakens. People with lupus become more prone to microorganisms, resulting in infections that are frequently not severe. Some of the more common infections are Herpes zoster (virus), Staphylococcus aureus (bacterium), Escherichia Coli (bacterium), Salmonella (bacterium), and Candida albicans (fungus).

How Are Infections Diagnosed in Someone with Lupus?

Diagnosing the symptoms of infection in someone with lupus can sometimes be tough because the symptoms resemble those of lupus. For example, it can be difficult to say whether joint pains and fever are due to a lupus flare or an infection. To complicate matters further, an infection can be a triggering factor for a lupus flare. A chronic low-grade fever may be normal for someone with lupus, it helps in taking the temperature at the same time daily. It is advised to consult the doctor in case of a temperature higher than usual or experience any symptoms that are not typical. The methods implemented to diagnose the presence of infection might include:

• Physical examination by your doctor

• Blood tests

• Urine tests

• Chest x-ray

• Cultures of the throat, blood, urine, or stool.

How Are Infections Treated in Someone with Lupus?

The medical treatment required to treat an infection in a person with lupus might be more prolonged than that required for people who do not have lupus. Treatment can vary as per the type of infectious agent. Some of the treatment protocols are:

1. Bacterial infections are treated with the help of antibiotics. This includes intravenous antibiotics and hospital admission for more critical infections, particularly if the person is on immunosuppressive drugs as a part of their lupus therapy.

2. Fungal infections are treated with the help of antifungal medications. They might be in the form of creams, suppositories, or oral medications.

3. Many viral infections (such as sinus infections, bronchitis, and colds) do not respond to treatment and should not be treated with antibiotics. Overuse of antibiotics can lead to bacteria becoming resistant to antibiotics and might make it harder to treat. In these situations, the doctor might advise the use of OTC (Over-the-Counter) treatments to help a person feel better at the time of infection (for example, pain relievers are given for pain, short-term use of nasal sprays can be done for a blocked or runny nose). Antiviral medication might be used for viral infections (for example, herpes zoster).

4. Some people with lupus might have an allergic reaction to sulfa antibiotics, which might cause increased photosensitivity, skin rashes, and a lowering of the white blood cell counts. This type of antibiotic can be avoided wherever possible.

Conclusion:

Lupus is an autoimmune disease in which the immune system starts attacking the body instead of protecting it. In this disease, inflammation can be seen all over the body. It can affect skin, heart, lungs, blood, etc. People with lupus are more susceptible to catching certain infections like herpes zoster, candida albicans, etc. These become tough to treat as well, and their symptoms resemble that of lupus. The treatment may vary according to the symptoms and part of the body involved.