To report a complex case of neuropsychiatric systemic lupus erythematosus (NPSLE) presenting with symptoms mimicking Japanese spotted fever (JSF), highlighting the diagnostic challenges.
Key Findings:
The patient exhibited symptoms of both NPSLE and JSF, including fever, respiratory failure, and altered consciousness, complicating the clinical picture.
PCR testing confirmed the presence of R. japonica in eschars, complicating the diagnosis and indicating a potential co-infection.
Clinical features suggested a severe autoimmune response consistent with NPSLE, necessitating prompt treatment.
Interpretation:
The case highlights the diagnostic complexity when autoimmune diseases present with infectious disease-like symptoms, necessitating careful evaluation and interdisciplinary collaboration.
Limitations:
The case report is based on a single patient, limiting generalizability and potential biases.
Diagnostic challenges may vary in different clinical settings, affecting the applicability of findings.
Conclusion:
This case underscores the importance of considering both infectious and autoimmune etiologies in patients with overlapping clinical features, particularly in endemic regions, to ensure timely and appropriate management.
