Table 1: Timeline of events. Date (2025): Event Aug 22: Presentation with fever, tachycardia, abdominal pain. CT: 8×4 mm right ureteral stone. Blood cultures grew E. coli. Urology placed stent. Started IV ceftriaxone. Aug 23-24: Stabilization of sepsis; thrombocytopenia noted. Persistent hypercalcemia identified. Aug 26: Nuclear medicine sestamibi scan: Right-lobe–adjacent persistent uptake (adenoma suspected). Surgery consulted. Aug 27: Renal function normalized, lactic acidosis resolved. Continued IV ceftriaxone. Sept 9 (planned): Completion of IV ceftriaxone. Endocrine surgery follow-up arranged.
|
Date (2025) |
WBC (×103/µL) |
Hgb (g/dL) |
Plt (×103/µL) |
Creatinine (mg/dL) |
Ca (mg/dL) |
PTH (pg/mL) |
25 (OH) Vitamin D (ng/mL) |
Notes |
|
Aug 22 (ED) |
15.5 ↑ |
11.8 |
160 |
0.9 |
10.4 ↑ |
- |
- |
Admission; lactic acid 2.6 mmol/L |
|
Aug 23 |
23.2 ↑ |
11.8 |
160 |
0.9 |
10.4 ↑ |
- |
- |
Peak leukocytosis |
|
Aug 24 |
11.7 ↑ |
11.4 |
147 ↓ |
0.8 |
11.0 ↑ |
- |
- |
Hypercalcemia noted; Platelets nadir |
|
Aug 26 |
10.4 ↑ |
11.6 |
168 |
0.7 |
10.7 ↑ |
- |
14 ↓ |
Nuclear medicine parathyroid scan performed |
|
Aug 27 |
7.1 |
11.8 |
193 |
0.7 |
9.8 |
179 ↑ |
14 ↓ |
PTH elevated; Renal function normalized |