Severe infections by opportunistic agents and common pathogens are frequent in patients suffering from systemic lupus erythematosus (SLE) and have become one of the leading cause of death. Here we review all cases of Streptococcus pneumoniae septicaemia observed in a cohort of 208 SLE patients. Five cases were identified. We stress the severity of the clinical presentation and recommend immunization of SLE patients with a pneumococcal polysaccharide vaccine.
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