CLINICAL CASES   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2001 June;160(3):123-6

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: Italian

An unusual case of haematuria

Bronzi G. ¹, Marini L. ²

¹ Divisione di Medicina Interna, P.O. S. Massimo di Penne - ASL Pescara; ² Università degli Studi «G. D’Annunzio» - Chieti, Istituto di Geriatria

The case described regards a female patient of 50 admitted for recurrent haematuria while she was in good subjective clinical condition. The diagnostic suspicion of a renal ETP or a primary glomerulonephritis, was discarded when she was submitted to US scan of the upper abdomen, because only multiple focal lesions were observed in the hepatic parenchyma, which CT examination showed to be of an abscess nature. Later US-guided aspiration led to the exit of pus, culture of which pointed to the presence of streptococcus intermedius. In the meantime the patient began to present septic fever with temperature rises coinciding with the episodes of haematuria. Target antibiotics therapy together with repeated US-guided drainage of the liver abscesses, led the patient to complete clinical and subjective cure and to the normalisation of instrumental laboratory examinations. The authors insist on the striking discrepancy between the purely renal admission symptomatology and the exclusively hepatic involvement in the imaging techniques. They also underline the atypical sepsis picture due to streptococcus, in this case intermedius, a common saprophyte of the oral cavity, but also the one most frequently associated with abscesses in deep parenchymas.