
Hypercalcemia mystery clarified and Cipro considerations for Pseudomonas
Dr. Roach reviews a 65-year-old with a very high calcium level (14 mg/dL). Although serious causes are possible, extensive testing and a good recovery years later make them unlikely; the most common cause is primary hyperparathyroidism, but pseudohypercalcemia from abnormal blood proteins or tourniquet artifact can mimic true hypercalcemia, and measuring ionized calcium can help confirm. In a second letter, he explains that treating Pseudomonas infections often requires ciprofloxacin, despite its risks, and that IV antibiotics may be needed if symptoms demand it; only treat when infection is likely (not just colonization), and monitor interactions with diuretics like hydrochlorothiazide.







