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Disseminated coccidioidomycosis associated with hypercalcemia

S A Westphal1

  • 1Department of Medicine, Maricopa Medical Center, Phoenix, Arizona, USA.

Mayo Clinic Proceedings
|September 16, 1998
PubMed
Summary

Disseminated coccidioidomycosis infection can cause hypercalcemia unrelated to vitamin D or parathyroid hormone. Pamidronate effectively treated this hypercalcemia in a patient with fungal infection.

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Area of Science:

  • Infectious Diseases
  • Endocrinology
  • Oncology

Background:

  • Disseminated coccidioidomycosis is a serious fungal infection.
  • Hypercalcemia is a potential complication of disseminated infections.
  • The etiology of hypercalcemia in coccidioidomycosis is not fully understood.

Observation:

  • A patient with disseminated coccidioidomycosis presented with hypercalcemia.
  • Laboratory results revealed low 1,25-dihydroxyvitamin D and suppressed parathyroid hormone levels.
  • These findings indicated that hypercalcemia was not mediated by vitamin D or parathyroid hormone.

Findings:

  • Hypercalcemia associated with disseminated coccidioidomycosis resolved rapidly after pamidronate administration.
  • This suggests pamidronate is an effective treatment for this specific type of hypercalcemia.
  • Calcium levels remained normal during subsequent antifungal therapy for Coccidioides immitis.

Implications:

  • Pamidronate should be considered for managing hypercalcemia in disseminated coccidioidomycosis.
  • Further research is warranted to elucidate the mechanisms of hypercalcemia in fungal infections.
  • This case highlights the importance of monitoring calcium levels in patients with disseminated coccidioidomycosis.

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