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Infections and Lupus

Reviewed by: HU Medical Review Board | Last reviewed: January 2020

People with lupus often catch more infections than other people. The reasons have to do with lupus itself and the medicines used to treat lupus, specifically immunosuppressants.1-2

Lupus can limit the body’s ability to fight bacteria and viruses. Plus, immunosuppressants stop the body’s immune cells from attacking healthy tissue. This helps reduce inflammation, pain, and organ damage, but it also makes the body less able to fight off infections.1-2

Types of infections common in lupus

The type of infections that people with lupus most often get are respiratory (sinuses and lungs), skin and urinary tract. A few of the most common infections seen in people with lupus are:1-4

  • Herpes zoster – A virus that causes chickenpox and shingles.
  • Staphylococcus aureus or Staph infection – A bacteria that causes mostly respiratory and skin infections, but can also infect the joints and bones.
  • Streptococcus pneumonia, which causes respiratory infections.
  • Escherichia coli or E. coli – A bacteria that causes stomach upset, diarrhea, and urinary tract infections.
  • Salmonella – A bacteria that causes stomach upset and diarrhea.
  • Klebsilla and pseudomonas – Pathogens that cause urinary tract infections and pneumonia.
  • Candida albicans – A fungus that naturally occurs in and on the body but can grow out of control, including in the throat (thrush), in the vagina (yeast infection), or the urinary tract (UTI).

Many infections can be mild to moderate in people with lupus, but serious complications are not uncommon. More than 20 percent of hospitalizations occur due to infections. Infections also account for 25 percent to 50 percent of all deaths in people with lupus.4

How are infections treated?

Infections in people with lupus are treated the same way as other people, and that depends on the type of infection. Infections caused by bacteria are treated with antibiotics but not sulfa drugs. People with lupus often have an allergic reaction to sulfa-based antibiotics. Fungal infections are treated with antifungals in the form of creams, suppositories, or pills. Viral infections, such as colds, do not respond to antibiotics, so over-the-counter remedies such as chicken soup, pain relievers, and nasal sprays may be recommended.1-2

How can infections be prevented?

Since infections are more common if lupus is active, sticking to your usual drug and self-care regime can help ward off infections. Your doctor will also try to keep you on the lowest dose of steroids possible since these drugs can reduce the body’s ability to fight infection.4

People with lupus can reduce their chances of getting an infection by following the same suggestions used in other people with weakened immune systems. This includes:

  • Frequent hand washing
  • Keeping a clean, dust-free house
  • Avoiding other people with a cold or the flu
  • Getting annual flu and pneumonia vaccinations
  • Treating cuts to the skin quickly
  • Taking a round of antibiotics before any dental or surgical procedure to prevent infections

Fever can be a sign of infection or a warning sign of a lupus flare. If you have a fever of 100 degrees Fahrenheit (F) or higher, contact your doctor right away.

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