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1.
BMJ Case Rep ; 15(9)2022 Sep 27.
Article in English | MEDLINE | ID: mdl-36167432

ABSTRACT

Hypercalcaemia is a relatively common metabolic disturbance seen in hospitalised patients; however, given the complicated systems of calcium regulation, it can take a significant amount of time and testing to pinpoint the aetiology. This case discusses a patient who developed acute hypercalcaemia from calcium sulfate-containing antibiotic beads placed during an orthopaedic procedure. These beads are used in surgical procedures to fill gaps/voids in bony structures and for local delivery of antibiotics. The case highlights the importance of careful review of a patient's hospital course, including the administration of medical products that may not be clearly documented on a patient's medicine administration record when working up an unexplained finding.


Subject(s)
Calcium Sulfate , Hypercalcemia , Anti-Bacterial Agents/adverse effects , Calcium , Calcium Sulfate/adverse effects , Calcium Sulfate/chemistry , Humans , Hypercalcemia/chemically induced , Hypercalcemia/drug therapy
2.
BMJ Case Rep ; 15(1)2022 Jan 07.
Article in English | MEDLINE | ID: mdl-34996770

ABSTRACT

Postoperative fevers are common in hospitalised patients and warrant workup beyond the early post-op period. A 50-year-old man was admitted after sustaining a tibial plateau fracture. Fevers began 3 days after external fixation and persisted through a second surgery despite initial negative workup. Careful review of medications revealed enoxaparin as the instigating agent of a febrile drug reaction, and the fevers resolved after discontinuing the drug. On further questioning, it was discovered the patient had an allergy to pork, from which the main components of enoxaparin are typically derived. To our knowledge, this is the first reported enoxaparin-induced fever in the setting of a pork allergy. Enoxaparin-induced fevers should be considered in patients with unexplained post-op fever. Our case demonstrates the importance of analysing newly administered medications. Simple detailed history may significantly reduce patient morbidity and help to broaden differentials during investigation.


Subject(s)
Fever of Unknown Origin , Hypersensitivity , Pork Meat , Red Meat , Animals , Anticoagulants/adverse effects , Enoxaparin/adverse effects , Humans , Male , Middle Aged , Postoperative Complications/chemically induced , Swine
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