摘要1例79岁女性患者因医院获得性肺炎给予莫西沙星400 mg,1次/d静脉滴注.当晚患者出现自言自语、焦虑,血压135/85 mm Hg(1 mm Hg=0.133 kPa).医嘱维持抗感染治疗.此后患者精神症状加重,表现为不认识家人、应答不切题、幻觉、狂躁不安等.应用莫西沙星5d后血压升至190/110mm Hg,体温39.6℃,脑电图无异常.停用莫西沙星,改用美罗培南0.5g,1次/8 h静脉滴注;并给予厄贝沙坦控制血压.2d后患者精神症状缓解,血压、体温恢复正常.2周后随访,出院后未再应用厄贝沙坦,血压基本正常,未再出现精神症状.

abstractsA 79-year-old female patient received an Ⅳ infusion of moxifloxacin 400 mg once daily for hospital acquired pneumonia.On the night,the patient experienced talking to herself,anxiety,and a blood pressure of 135/85 mm Hg.The anti-infective treatment continued following the doctor's advice.Hereafter she developed worsened psychic symptoms which included being not able to know families,irrelevant reply,hallucination,mania,and agitation.After infusion of moxifloxacin for 5 days,she presented with a blood pressure of 190/110 mm Hg,a temperature of 39.6 ℃,and a normal electroencephalogram.Moxifloxacin was stopped and changed to an Ⅳ infusion of meropenem 0.5 g once every 8 hours.Meanwhile,irbesartan was added to the regimen for control of blood pressure.Two days later,her psychic symptoms relieved and the blood pressure and temperature returned to within normal range.At a follow-up 2weeks later,her blood pressure remained normal basically when irbesartan was not taken again after discharge and psychic symptoms did not recur.