May 1980

Factitious Hematuria and Urinary Tract Infection

Author Affiliations

From the Departments of Medicine (Drs Kerr, Wilkinson, and Horler) and Psychiatry (Dr Schapira), University of Newcastle upon Tyne, England, and the Renal Unit, Leicester Royal Infirmary, Leicester, England (Dr Walls).

Arch Intern Med. 1980;140(5):631-633. doi:10.1001/archinte.1980.00330170047023

• A diagnosis of factitious hematuria and urinary tract infection was made in seven patients after delays of three months to 13 years. One patient spent two years in the hospital, and another underwent 16 intravenous urograms, six cystoscopies, and a nephrectomy before diagnosis. Helpful clues included rapid alternation of hematuria and normal urine, urine "passed" at room temperature, excessive lysed RBCs, and heavy bacterial growth in fresh urine, rapidly changing bacterial flora including saprophytes, healing cuts on fingers, and venipuncture scars. Self-inflicted wounds should also be sought in the bladder and vagina. Six patients had a background of family strife and emotional crisis that was revealed only by direct questioning. All were reluctant to accept psychiatric treatment, even when confronted with the evidence.

(Arch Intern Med 140:631-633, 1980)