Unusual presentation of more common disease/injury
Respiratory failure and symptomatic hypercalcaemia complicating pulmonary tuberculosis
1 St Thomas’ Hospital, Respiratory Medicine, Westminster Bridge Road, London, SE1 7EH, UK
2 The James Cook University Hospital, Respiratory Medicine, Marton Road, Middlesbrough, TS4 3BW, UK
Correspondence to:
Michael Waller, wallermd{at}hotmail.com
A 47-year-old Caucasian man was admitted to hospital with respiratory failure due to a severe pneumonia, requiring admission to the Intensive Care Unit (ICU) for respiratory support. Bronchial washings cultured Mycobacterium tuberculosis, a rare cause of respiratory failure, and fortunately he responded to standard antituberculous therapy. However, the patient subsequently developed symptomatic hypercalcaemia; an unusual complication of tuberculosis (TB) in the UK, probably contributed to by a combination of sunbathing and activation of 25-hydroxy vitamin D in the TB granuloma. The majority of patients treated for TB in the UK are probably vitamin D deficient and are therefore unlikely to become hypercalcaemic.
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