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Aktuelle Rheumatologie 2008; 33(3): 171-176
DOI: 10.1055/s-2008-1027596
Übersichtsarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Infektionen bei Patienten mit systemischem Lupus erythematodes – eine Übersicht

Infections in Patients with Systemic Lupus Erythematosus – a ReviewW. Handrick1 , A. Rodloff2 , M. Borte3
  • 1Institut für Medizinische Diagnostik Oderland, Frankfurt (Oder)
  • 2Institut für Medizinische Mikrobiologie und Infektionsepidemiologie, Universität Leipzig
  • 3Klinik für Kinder- und Jugendmedizin, Klinikum St. Georg gGmbh Leipzig
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Publication History

Publication Date:
03 July 2008 (online)

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Zusammenfassung

Infektionen sind bei Patienten mit systemischem Lupus erythematodes (SLE) häufig, sie gelten als wichtige Todesursachen. Die meisten Infektionen sind bakteriell bedingt, besonders häufig und z. T. schwer (evtl. letal) verlaufend sind Infektionen durch Pneumokokken und Enteritis-Salmonellen. Auch Mykobakterien, Viren, Pilze und Protozoen sind wichtige Infektionserreger. Als Dispositionsfaktoren zählen vor allem die Grundkrankheit und deren Therapie. Infektionen bei SLE-Patienten können nahezu alle Organe des Körpers betreffen. Die Diagnostik und die kalkulierte Antibiotika-Therapie müssen das breite Erregerspektrum berücksichtigen. Es besteht immer das Risiko, dass eine Infektion zunächst als akuter Lupus-Schub fehlgedeutet wird. Bei Patienten, die nicht bzw. ungenügend auf die Lupus-Therapie ansprechen, muss man immer an Infektionen denken. Alle Möglichkeiten der Infektionsprophylaxe sollten genutzt werden. Hierzu zählen Dispositionsprophylaxe (z. B. Schutzimpfungen), Expositionsprophylaxe (Hygiene, Ernährung) und Antibiotika-Prophylaxe (z. B. Cotrimoxazol, INH).

Abstract

Patients with systemic lupus erythematosus (SLE) have a higher infection rate than the general population. In fact, infections are an important cause of mortality. Most infections are caused by bacterial pathogens, very frequently encountered agents are pneumococci and Salmonella spp., and often have a severe or even lethal course. However, infections due to mycobacteria, viruses, fungi and protozoal agents are also observed. Both SLE itself and SLE therapy are the most predisposing factors for infections. Almost all parts of the body can be involved in these infections. With regard to diagnostic procedures and therapy, it is important to consider the wide spectrum of infectious agents. Infections can mimic a lupus flare, resulting in delayed diagnosis and treatment. The presence of an infection should always be sought in all SLE patients who does not respond to the usual therapy for a SLE flare. All possibilities should be used in order to prevent infections: vaccinations, hygiene, nutrition, and antibiotic prophylaxis (cotrimoxazole, INH).

Schlüsselwörter

systemischer Lupus erythematodes - Infektionen - Diagnostik - Therapie - Prophylaxe

Key words

systemic lupus erythematosus - infections - diagnostics - therapy - prevention

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Prof. Dr. W. Handrick

Institut für Medizinische Diagnostik Oderland

Am Kleistpark 1

15230 Frankfurt (Oder)

Phone: ++ 49/3 35/5 58 11 48

Fax: ++ 49/3 35/5 58 11 78

Email: W.Handrick@Institut-Oderland.de