Santhana Krishnan S G, Cobbs R K
Department of Internal Medicine, Metropolitan Hospital Center, New York, USA.
Postgrad Med J. 2006 Sep;82(971):e23. doi: 10.1136/pgmj.2006.047258.
A 38 year old man with history of obstructive sleep apnea and polycythaemia presented with hypercapnic respiratory failure that required intubation. He developed fever with infiltrates on chest radiography that required empiric antifungal therapy with fluconazole along with broad spectrum antibiotics. He developed acute adrenal insufficiency that recovered after fluconazole was stopped. It is believed that this complication of adrenal suppression attributable to fluconazole is underrecognised and it may be prudent to monitor all critically ill patients who are given fluconazole for this complication.
一名38岁男性，有阻塞性睡眠呼吸暂停和红细胞增多症病史，因高碳酸血症性呼吸衰竭而需要插管。他出现发热，胸部X光片显示有浸润影，需要使用氟康唑进行经验性抗真菌治疗以及广谱抗生素治疗。他出现了急性肾上腺功能不全，在停用氟康唑后恢复。据信，这种由氟康唑引起的肾上腺抑制并发症未得到充分认识，对于所有接受氟康唑治疗的重症患者监测这一并发症可能是谨慎之举。
