Active Exsanguination Behind a Urinary Tract Infection (UTI) Diagnostic Label: A Quadruple-Hit Cardiorenal Collapse Following Ambulatory Urological Care - Cureus
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We report the case of a 95-year-old man with a previous history of myocardial infarction, pulmonary oedema, and hypertension who developed recurrent collapse while undergoing ambulatory urological follow-up for a six-week history of macroscopic haematuria. Following a recent outpatient review, he had received oral antibiotics for a presumed urinary tract infection (UTI). Throughout this six-week ambulatory period, no full blood count or other blood tests were performed, leaving the extent of blood loss and its haematological consequences clinically occult. The patient subsequently experienced three episodes of sudden collapse within one week at home. The episodes were preceded by a prodrome of marked weakness. On assessment by ambulance clinicians, a profound postural blood-pressure drop was identified. Given the postural component and presumed recent urinary infection, dehydration was considered the initial explanation, and intravenous fluid resuscitation was commenced. However, hospital point-of-care investigations substantially changed the diagnostic picture. Venous blood gas analysis demonstrated a haemoglobin concentration consistent with profound anaemia. ECG demonstrated a r
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Jiménez-Gómez has received support for attending meetings and/or travel from Oximesa Nippon Sanso. The other authors have declared no conflicts of interest. Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.
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