When you have lupus, you are at increased risk for all kinds of infections. There are two main reasons for this higher risk: lupus disease and treatments.

Risk Factors

First, lupus itself can make infections occur more often. Lupus affects the immune system, which can sometimes limit the body’s ability to fight bacteria, viruses and other microbes that can cause illness. 

This is because lupus can cause hyperactivity of certain immune cells. This creates antibodies that attack the immune system. 

Second, people with lupus often take immunosuppressive medicines to control their overactive immune system. These drugs can limit the ability of your body’s immune system to respond, and can leave you more open to infectious agents.

The most common infections in people with lupus involve the respiratory system (lungs and airways), the skin, and the urinary tract. People with lupus are also at high risk for developing Candidiasis, sometimes called thrush or yeast infection, and shingles (the same viral infection as chicken pox). People on immunosuppressive medicines are also at higher risk of COVID-19 infection.

Overall, infections tend to last longer and bacterial infections may require a longer period of treatment with antibiotics. Sulfa antibiotics, a class of drugs commonly used to treat infections, should be used very carefully in people with lupus. These drugs can increase sensitivity to light and skin rashes, and can lower white blood cell counts. 

Tips to Stay Healthy

If you have lupus, it’s important that you stay up-to-date with your flu shot and other vaccines. Vaccines help increase antibodies that fight infectious germs that may enter your body. 

You should do your best to avoid anyone who appears sick and wash your hands often. It may be necessary to wear a mask in crowded public places. 

What to do if you get ill

Sometimes what appears to be an infection -- with fever and inflammation -- may be a lupus flare. A lupus flare, or flare up, is when your lupus symptoms worsen and cause you to feel ill. 

If you have a fever of 100 degrees Fahrenheit (F), or 37 degrees Celsius, or higher, you should contact your doctor right away. A fever can be a warning sign of a lupus flare or an underlying infection. A fever can be serious if you are taking corticosteroids, potent immunosuppression or chemotherapy drugs. 

For serious infections, your doctor may pause your immunosuppressive medicines. Also be sure to tell your doctor if you have any upcoming medical procedures, including dental work.