Fig. 2.

Clinical course during hospitalization. After initiation of levofloxacin treatment, serum CRP level decreased, whereas serum sodium level began to decrease and serum calcium level began to increase. CRH test and provocation test were then performed, because the presence of adrenal insufficiency was highly suspected. After the diagnosis of adrenal insufficiency, intravenous administration of hydrocortisone followed by oral hydrocortisone replacement was initiated. Soon after the replacement of hydrocortisone, the sensation of fatigue rapidly disappeared. Furthermore, hypercalcemia and hyponatremia were normalized. Ca calcium, CRH corticotropin-releasing hormone, CRP C-reactive protein, iv intravenous, Na sodium