A Case of Late-Onset Hypocalcemic Tetany Precipitated by Sequential Viral Infections in a Post-Thyroidectomy Patient

Background: Hypocalcaemia is an ordinary issue that may present after a thyroidectomy; nevertheless, it's not as widely known that it may flare up later because of an underlying illness. Specifically, this report addresses how multiple viral infections might contribute to catastrophically low calcium levels in a vulnerable patient.

Case Presentation: In November 2024, a 62-year-old woman with a past of a total thyroidectomy three years preceding that was complicated by an unintentional parathyroidectomy and protracted hypoparathyroidism proceeded to the emergency room with acute hypocalcemic tetany. Before she turned hospitalised, she had two infections in a sequence: a severe respiratory virus and an entirely new confirmed SARS-CoV-2 (COVID-19) infection. She had been consistent on a set regimen of calcium and calcitriol previously.

Intervention: The patient received medical treatment shortly thereafter with calcium gluconate infused through an IV, which interrupted the tetany. subsequent to that, her long-term therapy schedule was amended to include a higher dose of calcitriol and calcium.

Outcomes: The patient's serum calcium levels reverted approximately normal, and she was transported residence with a new, stabilised medication approach.

Conclusion: This case demonstrates how individuals who have had a thyroidectomy who currently have chronic hypoparathyroidism do not possess an abundance of metabolic balance. Hypocalcaemia can be life-threatening when it develops by systemic stressors, especially multiple viral infections. It highlights how important it is to instruct patients how to manage their days off and to implement temporary dose adjustments when they have more than one infection intercurrent illnesses.