To the Editor.
—In the February 1987 issue of the Archives, the article "Bacteremic Hypocalcemia" by Aderka et al1 reports a greater incidence of hypocalcemia in bacteremic patients compared with nonbacteremic patients, with hypocalcemia more prominent in male patients. Although the authors acknowledge that the mechanism for hypocalcemia is unclear, the possible importance of magnesium deficiency in these patients needs to be emphasized. Both impaired parathyroid hormone release and end-organ resistance to parathyroid hormone action have been well documented in patients with magnesium deficiency,2 which has many possible etiologies other than the aminoglycoside therapy discussed by the authors. Alcohol abuse and diabetes mellitus, conditions that predispose to severe infections, also are major causes of magnesium deficiency, as are diarrhea and loop diuretic therapy.3 Did the bacteremic population have more conditions that predisposed to magnesium depletion than did the nonbacteremic group? Was alcohol intake more prominent in male
Ryzen E, Rude RK. Magnesium Deficiency in Bacteremic Patients. Arch Intern Med. 1988;148(1):249-253. doi:10.1001/archinte.1988.00380010251034