Severe Symptomatic Hypercalcemia Caused by Antibiotic Bead Placement

Severe hypercalcemia is a rare but potentially fatal complication of calcium sulfate antibiotic beads, particularly in patients with impaired renal function. We present the case of a 77-year-old man with end-stage renal disease who developed symptomatic hypercalcemia (serum calcium level, 17.7 mg/dL; albumin-corrected level, 18.3 mg/dL) 8 days after bead placement for chronic prosthetic hip infection. He presented with altered mental status and junctional arrhythmias despite adherence to hemodialysis. Management required multiple daily hemodialysis sessions with a low-calcium bath and intravenous pamidronate. His calcium level normalized over 1 week. This case highlights the importance of cautious bead use and vigilant postoperative monitoring in patients who receive dialysis.