Severe symptomatic hypocalcemia due to Cyclospora cayetanensis infestation: A rare case

Introduction: Severe hypocalcemia can affect multiple systems, causing a wide variety of symptoms ranging from muscle weakness to twitching. In severe cases, it can lead to heart rhythm disturbances and seizures. A rare cause of hypocalcemia is due to malabsorption associated with prolonged gastroen...

Full description

Saved in:
Bibliographic Details
Main Authors: Ali Ajmal, Camelia Chirculescu, Tariq Alyamani, Gregory J. Hiett, Dhan Bahadur Shrestha
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:IDCases
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2214250925000125
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850035248563224576
author Ali Ajmal
Camelia Chirculescu
Tariq Alyamani
Gregory J. Hiett
Dhan Bahadur Shrestha
author_facet Ali Ajmal
Camelia Chirculescu
Tariq Alyamani
Gregory J. Hiett
Dhan Bahadur Shrestha
author_sort Ali Ajmal
collection DOAJ
description Introduction: Severe hypocalcemia can affect multiple systems, causing a wide variety of symptoms ranging from muscle weakness to twitching. In severe cases, it can lead to heart rhythm disturbances and seizures. A rare cause of hypocalcemia is due to malabsorption associated with prolonged gastroenteritis. Case presentation: We present a 35-year-old female with persistent watery diarrhea of eight weeks presented with neuromuscular symptoms. Trousseau sign and Chvostek sign were positive bilaterally. Laboratory test results revealed severe hypokalemia, hypocalcemia, and anemia, with prolonged QT interval in electrocardiogram (EKG). Her stool polymerase chain reaction (PCR) revealed Cyclospora cayetanensis. Her electrolytes were appropriately replaced during her hospital stay. The patient was successfully treated with trimethoprim-sulfamethoxazole, calcium, and oral iron supplementation. Conclusion: This case demonstrates a unique presentation of a healthy young female with symptomatic hypocalcemia resulting from malabsorption due to Cycolospora cayetanensis. This case emphasizes the importance of early diagnosis using newer techniques, such as polymerase chain reaction (PCR) for parasite DNA, which can result in appropriate diagnosis and timely treatment.
format Article
id doaj-art-c43f0b876ff14d5f80166a97cd155579
institution DOAJ
issn 2214-2509
language English
publishDate 2025-01-01
publisher Elsevier
record_format Article
series IDCases
spelling doaj-art-c43f0b876ff14d5f80166a97cd1555792025-08-20T02:57:32ZengElsevierIDCases2214-25092025-01-0139e0215710.1016/j.idcr.2025.e02157Severe symptomatic hypocalcemia due to Cyclospora cayetanensis infestation: A rare caseAli Ajmal0Camelia Chirculescu1Tariq Alyamani2Gregory J. Hiett3Dhan Bahadur Shrestha4Division of Endocrinology, Department of Medicine, Joan C. Edwards School of Medicine-Marshall Univeersity, Huntington, West Virginia 25701, USA; Corresponding author.Department of Internal Medicine, Johnston Memorial Hospital, Abingdon, VA 24211-7664, USADepartment of Internal Medicine, Johnston Memorial Hospital, Abingdon, VA 24211-7664, USADepartment of Internal Medicine, Johnston Memorial Hospital, Abingdon, VA 24211-7664, USADivision of Cardiology, Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY 13326, USAIntroduction: Severe hypocalcemia can affect multiple systems, causing a wide variety of symptoms ranging from muscle weakness to twitching. In severe cases, it can lead to heart rhythm disturbances and seizures. A rare cause of hypocalcemia is due to malabsorption associated with prolonged gastroenteritis. Case presentation: We present a 35-year-old female with persistent watery diarrhea of eight weeks presented with neuromuscular symptoms. Trousseau sign and Chvostek sign were positive bilaterally. Laboratory test results revealed severe hypokalemia, hypocalcemia, and anemia, with prolonged QT interval in electrocardiogram (EKG). Her stool polymerase chain reaction (PCR) revealed Cyclospora cayetanensis. Her electrolytes were appropriately replaced during her hospital stay. The patient was successfully treated with trimethoprim-sulfamethoxazole, calcium, and oral iron supplementation. Conclusion: This case demonstrates a unique presentation of a healthy young female with symptomatic hypocalcemia resulting from malabsorption due to Cycolospora cayetanensis. This case emphasizes the importance of early diagnosis using newer techniques, such as polymerase chain reaction (PCR) for parasite DNA, which can result in appropriate diagnosis and timely treatment.http://www.sciencedirect.com/science/article/pii/S2214250925000125HypocalcemiaTrousseau signChvostek signCyclospora cayetanensis
spellingShingle Ali Ajmal
Camelia Chirculescu
Tariq Alyamani
Gregory J. Hiett
Dhan Bahadur Shrestha
Severe symptomatic hypocalcemia due to Cyclospora cayetanensis infestation: A rare case
IDCases
Hypocalcemia
Trousseau sign
Chvostek sign
Cyclospora cayetanensis
title Severe symptomatic hypocalcemia due to Cyclospora cayetanensis infestation: A rare case
title_full Severe symptomatic hypocalcemia due to Cyclospora cayetanensis infestation: A rare case
title_fullStr Severe symptomatic hypocalcemia due to Cyclospora cayetanensis infestation: A rare case
title_full_unstemmed Severe symptomatic hypocalcemia due to Cyclospora cayetanensis infestation: A rare case
title_short Severe symptomatic hypocalcemia due to Cyclospora cayetanensis infestation: A rare case
title_sort severe symptomatic hypocalcemia due to cyclospora cayetanensis infestation a rare case
topic Hypocalcemia
Trousseau sign
Chvostek sign
Cyclospora cayetanensis
url http://www.sciencedirect.com/science/article/pii/S2214250925000125
work_keys_str_mv AT aliajmal severesymptomatichypocalcemiaduetocyclosporacayetanensisinfestationararecase
AT cameliachirculescu severesymptomatichypocalcemiaduetocyclosporacayetanensisinfestationararecase
AT tariqalyamani severesymptomatichypocalcemiaduetocyclosporacayetanensisinfestationararecase
AT gregoryjhiett severesymptomatichypocalcemiaduetocyclosporacayetanensisinfestationararecase
AT dhanbahadurshrestha severesymptomatichypocalcemiaduetocyclosporacayetanensisinfestationararecase