静脉滴注氟康唑致精神异常

Mental disorders attributed to an IV infusion of fluconazole

1例87岁男性患者,因慢性阻塞性肺疾病(COPD)急性发作和白色念珠菌感染,静脉滴注氟康唑0.4 g,1次/d。当晚出现兴奋、烦躁、乱语、双手颤抖等症状。第3天将氟康唑剂量降至0.2 g,1次/d,同时给予抗精神病药物,但患者的精神症状仍进行性加重。第5天停用氟康唑,改为口服伊曲康唑胶囊,患者精神症状消失。第8、10天痰培养结果均为阴性,COPD症状缓解。出院后15 d电话随访,患者未再出现精神异常。

An 87 year-old male patient received an IV infusion of fluconazole 0. dg once daily for chronic obstructive pulmonary disease （COPD） and Candida albicans infection. The patient experienced agitation, anxiety, delirium, and trembling of his hands at the night. On day 3, the dose of fluconazole reduced to 0.2 g once daily, and a antipsychotic medication was given. But the patient＇ s mental symptoms was progressively exacerbated. On the day 5, flueonazole was discontinued, and itraconazole capsules were given orally. The patient＇s mental symptoms disappeared. On days 8 and 10, sputum cultures results were negative, and the symptoms of COPD was relieved. The patient＇s mental symptoms did not reappear on telephone follow-up at 15 days after discharge.