Variably acid-fast bacteria in a necropsied case of systemic lupus erythematosus with acute myocardial infarction.

A 41-year-old woman with chronic systemic lupus erythematosus (SLE), uncomplicated by sepsis or other "secondary infection," died of an acute myocardial infarction. All of the available necroscopic material was reviewed to determine whether acid-fast cell wall deficient bacteria (CWDB) could be demonstrated in vivo. Variably acid-fast coccoid forms, suggestive of CWDB, were observed in specially-stained (intensified Kinyoun acid-fast stain) microscopic sections of the heart, lungs, kidney, adrenal glands, brain, connective tissue, and other organs. Acid-fast "hematoxylin bodies" were also observed. The finding of variably acid-fast bacteria in postmortem tissue in SLE may relate to the current finding of variably acid-fast CWDB within the blood stream of "normal" and diseased persons. In addition, the finding of acid-fast bacteria may relate to the previous reports of similar bacteria in scleroderma, pseudoscleroderma, and cutaneous lesions of SLE. The further search for CWDB in necropsied cases of SLE may elucidate the possible pathogenic role, if any, of these microbes in SLE.