A Case of Hypercalcemia Secondary to Disseminated <i>Cryptococcus neoformans</i> Infection

Fungal infection is a rare cause of hypercalcemia, thought to be mediated by extrarenal conversion of 25-hydroxy-vitamin-D to 1,25-dihydroxy-vitamin-D within granulomas. Only 6 cases involving Cryptococcus neoformans have been reported in the literature, with prior cases varying in their treatment approach. We report a 7th case in a patient with disseminated infection and laboratory findings consistent with the proposed mechanism. This case underscores the importance of checking calcium levels in all patients with cryptococcal infection, regardless of symptoms, to identify hypercalcemia warranting treatment. Furthermore, this case demonstrates the efficacy of fluids, calcitonin, and bisphosphonate in treating cryptococcal hypercalcemia.