Case 39-2003: A 33-Year-Old Woman with Gross Hematuria

Presentation of Case A 33-year-old woman was admitted to the hospital because of gross hematuria. The patient had been in stable health until four days earlier, when gross hematuria developed, with passage of clots and mild dysuria but without an increase in urinary frequency. She came to this hospital, where a urine specimen was obtained for culture and where a presumed urinary tract infection was treated with trimethoprim–sulfamethoxazole; she also was referred to a urologist. The hematuria and clots persisted and worsened two days before admission. One day before admission, the urine culture yielded a few mixed bacteria. An attempted . . .