Systemic lupus erythematosus (SLE) or Lupus is a chronic and idiopathic autoimmune connective tissue disease that involves several organs and organ systems. SLE may lead to a group of psychiatric manifestations, including delirium, anxiety disorders, cognitive dysfunction, mood disorders, and psychosis, which are caused by organic or non-organic factors. In addition, it is thought that the most common cause of neuropsychiatric lupus is corticosteroid use; central nervous system involvement and inflammatory processes also have an important role in the development of psychiatric manifestations. In other respects, structural brain abnormalities induce proneness to psychotic and manic symptoms. Along with this proneness, cavum vergae, an anomaly closely related to the anatomic areas associated with mood regulation, may precipitate manic symptoms. In this case report, we present a manic episode case emerging after delirium, with a 1-year history of SLE, which has recently been diagnosed with cavum vergae and discuss the process of infection and corticosteroid treatment, which contributed to the proneness effect of a structural brain anomaly.