Jumbled

A 62 year old woman presents with fever, vomiting, and dysuria for 3 days.

Further questioning reveals a history of dizziness and easy fatigability for the last 3 months, along with frothy urine.

Her medical history is significant for Hepatitis C infection diagnosed 3 years ago. She defaulted on follow up thereafter.

She does not smoke or consume alcohol, and denies drug abuse.

Choisissez les Examens Pertinents
Renal Functions + eGFR

Faits

BUN: 60 mg/dL (20-30)
Serum creatine: 2.2 mg/dL (0.4-1.1)
eGFR: 61 ml/min/1.73m2
Anti-HCV Abs & HCV RNA

Faits

The enzyme immunoassay for anti-HCV antibodies is reactive.
The HCV RNA test is positive.
USS Abdomen & Pelvis

Faits

Both kidneys are mildly enlarged. The liver is of normal size and echogenicity. No other abnormalities are noted.
Urinalysis + Culture & ABST

Faits

Color: Yellow & Turbid
Urinary Protein: ++
Urinary Glucose: none
Pus Cells: 50-55/hpf
Red Cells: occasional
Epithelial Cells: occasional
White cell casts: +
Organisms: +
Gram Stain: multiple gram negative rods
Culture: results will be available in 3 days

Choisissez les Prises en Charge Pertinentes
Anti-HCV Therapy
Corticosteroids
Antihypertensives
IV Ceftriaxone