Reversible acute adrenal insufficiency caused by fluconazole in a critically ill patient.
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.
Santhana Krishnan
S G
SG
Department of Internal Medicine, Metropolitan Hospital Center, New York, USA. sgskrishnan@hotmail.com
Cobbs
R K
RK
D000208:Acute Disease; D000309:Adrenal Insufficiency / Q000139:chemically induced*; D000328:Adult; D000935:Antifungal Agents / Q000009:adverse effects*; D016638:Critical Illness; D015725:Fluconazole / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009181:Mycoses / Q000188:drug therapy*; D012891:Sleep Apnea Syndromes / Q000150:complications
D000935:Antifungal Agents; D015725:Fluconazole