Presentation


An otherwise healthy male patient developed urinary retention and excessive hematuria with bright red clots that appeared every time he urinated. At that time, he was in Mexico with his family, so he visited a local hospital, where he reported severe blood loss that required a transfusion. Upon returning to the U.S., he experienced suprapubic abdominal pain and some dysuria, but had no fever, chills, shortness of breath or chest pain, and the hematuria had significantly improved. Blood cultures remained negative for growth, however, the visibly bloody urine grew Escherichia coli, which was resistant to ertapenem, but susceptible to other carbapenems, and was negative by CarbaNP testing for carbapenemase activity.

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Author Information

Adam Caulfield, Ph.D., D(ABMM), Technical Director of Microbiology, Corewell Health
Austin Woods, MLS(ASCP)CM, Microbiology Technical Specialist, Corewell Health West Regional Lab
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