Cavitary lesion of the lung as a complication of systemic lupus erythematosus

A report of two cases successfully treated by antimicrobial therapy

Abstract

Two patients with lupus nephropathy developed cavitary lesion of the lung while receiving a high-dose prednisolone therapy. In the first patient, Bacillus cereus and Nocardia asteroides were isolated from materials aspirated by percuaneous needle biopsy of the lung. She was successfully treated by the antimicrobial regimen based on sensitivity studies. In the second patient, the use of trimethoprim-sulfamethoxazole proved to be highly effective, suggesting that the cavitary lesion in this case was also of infectious origin.
Cavitary lesion developing as a complication in patients with systemic lupus erythematosus is a diagnostic as well as a therapeutic challenge. The importance of definitive diagnostic measures such as lung biopsy was stressed and reports of opportunistic infections as a cause of cavitary lesion were reviewed.