Additionally, the cornea and spine may also be affected.[12] Individuals with a compromised immune system are vulnerable to contracting such infections, which include factors such as glucocorticoid usage, malignancy, organ and hematopoietic stem cell transplantation, HIV infection, chronic obstructive pulmonary disease, systemic lupus erythematosus, chronic kidney disease, and other susceptibility factors such as diabetes, alcohol abuse, chronic sarcoidosis, use of tumor necrosis factor-alpha inhibitors, inflammatory bowel disease, and hospital-acquired infections. This evidence concerns the gene TNF and systemic lupus erythematosus.