For SLE with CNS involvement, standard treatment involves high-dose corticosteroids (such as methylprednisolone) and powerful immunosuppressants like cyclophosphamide or rituximab to reduce brain inflammation. Hydroxychloroquine is also prescribed to control overall lupus. However, because you have a history of pyogenic meningitis and recurrent fevers, these immunosuppressing drugs greatly increase your infection risk. Your medical team, including a rheumatologist and an infectious disease specialist, will need to customise your regimen carefully, potentially prescribing prophylactic antibiotics and closely monitoring you to balance controlling the lupus while preventing another life-threatening infection.