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Clinical Case for Residents (VI)-24-year-old woman with recent-onset SLE presenting with subacute meningeal syndrome

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This document is part of the Clinical Cases for Residents collection, a teaching project aimed at postgraduate training in Rheumatology and also applicable to other medical specialties involved in the management of systemic diseases. Its purpose is to strengthen clinical reasoning skills, syndromic analysis, and the structured development of differential diagnoses in complex clinical scenarios.

The case presents the clinical evaluation of a young patient with recently diagnosed systemic lupus erythematosus who develops a subacute meningeal syndrome while receiving immunosuppressive therapy. The discussion focuses on the differential diagnosis of neurological manifestations in patients with SLE, particularly the distinction between neuropsychiatric lupus and infectious central nervous system complications in immunocompromised hosts.

The document reviews the key clinical, analytical, and cerebrospinal fluid findings that guide the diagnostic reasoning process, highlighting the importance of recognizing opportunistic infections such as Listeria monocytogenes meningitis, which may present with atypical cerebrospinal fluid features in immunosuppressed patients.

The case is designed as a teaching tool for medical residents, incorporating group-based discussion, guided clinical reasoning, and integration of clinical, laboratory, and imaging findings. It forms part of a collection aimed at reinforcing advanced competencies in differential diagnosis, integrative clinical analysis, and evidence-based decision-making in real-world clinical practice.

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Clinical Case for Residents (VI)-24-year-old woman with recent-onset SLE presenting with subacute meningeal syndrome