Rianthavorn P, et al. - Medical records of 179 individuals, who were admitted to a tertiary-care university-based hospital from January 2002 to July 2018 with the diagnosis of SLE, were evaluated in order to assess risk factors for fatal infection in children with lupus nephritis in under-resourced areas. In 72 of 375 episodes of hospital admissions, hospital-acquired infections occurred and 13 hospital-acquired infections led to a fatal infection. The chief cause of death was invasive fungal infections with pulmonary infections being the principal site. The influences of invasive fungal infections and high neutrophil-to-lymphocyte ratio were increased by a high daily prednisolone dose on the prognosticated probability of infection-related mortality. In conclusion, in the routine clinical practice of children with lupus nephritis in under-resourced areas, prevention of invasive fungal infections and reduction of daily prednisolone should be reflected to attain superior survival. Moreover, for infection, children with lupus nephritis and a high neutrophil-to-lymphocyte ratio should be under careful surveillance.