In this covid 19 pandemic,there were increased incidence of Mucormycosis and thereby increase in
usage of antifungals especially oral posaconazole which is more recently available in tablet form.There
are already enough case reports of the incidence of new onset hypertension and hypokalemia with supressed renin and
aldosterone which is termed as “Posaconazole induced pseudohyperaldosteronism”.We describe here about a similar case that
presented with hypertensive urgency as Acute pulmonary edema with an associated primary adrenal insufciency.The potential
mechanism include inhibition of 11 β HSD which degrades cortisol to cortisone,thereby increasing the levels of cortisol that
stimulates Mineralocorticoid receptor.Also there is inhibition of steroidogenesis at the level of adrenal which in our patient
presented with features of Acute adrenal insufciency.