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A woman in her late 70s on haemodialysis with type-2 diabetes and microscopic polyangiitis was admitted for treatment of a flare-up of vasculitis. One day, the patient developed abdominal pain and fever. Vital signs showed a body temperature of 39.0°, a blood pressure of 90/52 mm Hg and a heart rate of 118 beats/min. Tenderness was noted in the lower abdomen. Urinalysis showed red and white cell counts >50 per high power field, and gram-negative rods were detected in the urine by Gram …
Contributors SF cared for the patient with assistance from HT and MO. SF obtained publication consent from the patient’s family. SF drafted the manuscript, and HT and MO revised the draft critically. All authors approved the final version of the manuscript and agree to be accountable for all aspects of the work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.