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。 One 87-year-old male patient received intravenous fluconazole 0.4 g once daily for acute episodes of chronic obstructive pulmonary disease (COPD) and C. albicans infection. Excitement, irritability, gossip, trembling hands and other symptoms appear that night. Day 3 Fluconazole dose was reduced to 0.2 g, 1 / d, given antipsychotics, but the patient’s psychiatric symptoms are still progressive increase. Fluconazole was discontinued on day 5, and itraconazole capsules were taken orally. The patient’s psychiatric symptoms disappeared. On the 8th and 10th days, sputum culture results were negative and COPD symptoms were relieved. 15 days after discharge telephone follow-up, patients no longer appear mental disorders.