Severe allergic reaction to hydrochlorothiazide mimicking septic shock.

Hydrochlorothiazide (HCTZ) is a sulfonamide-containing drug with commonly reported adverse effects that include electrolyte abnormalities, orthostatic hypotension, hyperglycemia, and photosensitivity. A few reports have described rare but serious drug complications such as interstitial pneumonitis, angioedema, and aplastic anemia. We describe a patient who experienced a serious HCTZ-induced adverse event that, to our knowledge, has not yet been reported in the literature.

Intensive insulin therapy for acute hyperglycemia.

There is growing evidence that control of hyperglycemia in the critically ill patient improves outcome. Normalizing blood glucose levels decreases the risk of developing sepsis, end-organ damage, and hospital mortality. Critical care clinicians must be familiar with current and benchmark research supporting control of hyperglycemia and use this knowledge to ensure appropriate application of evidence-based practice for decreasing or preventing complications in the critically ill patient.