Two unusual cases of severe recalcitrant hypocalcemia due to aminoglycoside-induced hypomagnesemia
A 46-year-old male, a case of MDR-TB who has stopped treatment twice and now on second line ATT including kanamycin for past one year, came to hospital with generalized tonic-clonic convulsion and altered sensorium. He had no history of headache, vomiting or fever at time of admission. On examination, patient was drowsy; however, rest of neurological examination was normal. He also had bilateral pleural effusion with bilateral lower lobe consolidation []. His investigation [] revealed hypocalcemia, hypomagnesemia, and hypermagnesuria. His treatment was modified, kanamycin was stopped, and magnesium and calcium supplementation was started. Within four weeks of treatment, patient showed improvement both biochemically and clinically.