This study demonstrates demographic, clinical and laboratory characteristics 
with special reference to infections in Saudi patients with SLE. One-hundred and 
ninety-nine patients with SLE treated at Riyadh Armed Forces Hospital, Saudi 
Arabia over a period of 15 years (1990-2005) were retrospectively reviewed. 
There were 162 females and 37 males (4.4 : 1) with an average age of 35 years at 
onset of disease. Duration of diseases ranged from one to 23 years with a mean 
of 7.23 years. Some of the clinical characteristics of SLE patients observed 
were nephritis (53.7%), fever (53.26%), neuropsychological disorder (36.18%), 
malar/butterfly rash (27.6%), pulmonary disorder (22.6%), photosensitivity 
(21.6%), cardiac involvement (21.1%) and oral ulcers (19.09%). Infection was the 
major complication with 58.79% of SLE patient having suffered from various 
infections. A total of 22 species of pathogens including gram positive and gram 
negative bacteria, viruses and fungi were isolated from 117 SLE patients. Single 
to multiple episode of infection with various pathogens were recorded however, 
majority of patients harboured one or two species of pathogens. Bacterial 
infection was predominant (78.6%) followed by viral (28.2%) and fungal (28.2%) 
infections. Forty-four percent of SLE patients were found to be infected with 
organisms classified as opportunistic. The high incidence of infections in SLE 
patients may be attributed to the multiple intrinsic and extrinsic risk factors 
including deficiency of complement (C3 and C4), disease activity, renal 
impairment, use of glucocorticoid and cytotoxic drugs. It is concluded that more 
judicious use of corticosteroids and other immunosuppressive agents will be 
critical to limit the infections in SLE and a high alert and close monitoring of 
patients will ensure optimal patient outcome, both in terms of morbidity and 
mortality.