A.R. GARAEVA¹, E.A. FEDOROVA¹, N.G. SHAMSUTDINOVA¹, S.A. LAPSHINA¹, S.P. YAKUPOVA¹, E.V. DYAKOVA², B.A. MAGOMEDOV², E.R. MYASOUTOVA², D.I. ABDULGANIEVA^1, 2

 ¹Kazan State Medical University, Kazan

²Republic Clinical Hospital, Kazan

 Contact details:

Garaeva A.R. — resident physician of the Department of Hospital Therapy

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-917-865-70-95, e-mail: alina-garaeva97@mail.ru

This article presents a clinical case of severe bacterial pneumonia in a patient with juvenile systemic lupus erythematosus, which arose under the guise of systemic lupus erythematosus exacerbation. The patient was first admitted with a typical picture of systemic disease exacerbation; nevertheless, a detailed diagnosis showed an inflammatory process in lungs. The concomitant pathology in lungs made it difficult to detect new lesions. At first, new coronavirus infection was excluded. Computed tomography scan showed the focus of rapid consolidation, which was transformed into a gangrenous abscess. First-line treatment caused a number of difficulties – an adequate immunosuppressive therapy for systemic lupus erythematosus was impossible due to the rapid progression of lung’s inflammation; in turn, the immune-mediated inflammatory disease aggravated and prevented the rapid resolution of bacterial pneumonia. It was decided to surgically treat the patient, with further selection of conservative therapy.

Key words: systemic lupus erythematosus, complicated pneumonia, bacterial infection.

REFERENCES

1. Vsemirnaya organizatsiya zdravookhraneniya [World Health Organization], available at: https://www.who.int/ru (accessed on: 20.04.2022).
2. Peng L., Wang Y., Zhao L., Chen T. et al. Severe pneumonia in Chinese patients with systemic lupus erythematosus. Lupus, 2020,  vol. 29 (7),  rr. 735–742.
3. Klyukvina N.G., Aseeva E.A., Nikonorova N.O. Lung damage in systemic lupus erythematosus: well-known facts and unresolved issues. Nauchno-prakticheskaya revmatologiya, 2016,  no. 5 (in Russ.).
4. Lee J., Dhillon N., Pope J. All-cause hospitalizations in systemic lupus erythematosus from a large Canadian referral centre. Rheumatology (Oxford), 2013,  vol. 52,  rr. 905–909.
5. Li W., Chen W., Huang S., Tang X. et al. Infection with Opportunistic Bacteria Triggers Severe Pulmonary Inflammation in Lupus-Prone Mice. Mediators Inflamm, 2019.
6. Belov B.S., Polyanskaya M.V., Tarasova G.M., Naumtseva M.S. Pneumonia in rheumatic diseases: current state and prospects. Nevrologiya i revmatologiya. Prilozhenie k zhurnalu Consilium Medicum, 2011,  no. 2,  pp. 32–35 (in Russ.).
7. Rúa-Figueroa Í., López-Longo J., Galindo-IzquierdoM. et al. Incidence, associated factors and clinical impact of severe infections in a large, multicentric cohort of patients with systemic lupus erythematosus. Semin Arthritis Rheum, 2017,  vol. 4,  pp. 38–45.
8. Tarasova G.M., Belov B.S., Dilbaryan A.G. et al. Meditsinskiy sovet, 2018,  no. 18,  pp. 86–91 (in Russ.).