Bang! The smoker with suprapubic pain.

摘要

In July, 2006, a 59-year-old man from Macedonia presented with a 6-week history of progressive suprapubic pain. The pain was chronic with sharp episodes, and radiated to the back. He also had loss of appetite, recurrent episodes of nausea, 6 kg weight loss, periods of drenching sweats, and experienced burning sensation when urinating. He was a heavy smoker (80 pack-years). On clinical examination our patient was cachectic, was afebrile, had no lymphadenopathy, but had suprapubic tenderness. Peripheral pulses were normal. Laboratory test results showed normocytic anaemia (haemoglobin 132 g/L) with normal leucocyte and platelet counts, monocytosis (10-3%), and a high concentration of C-reactive protein (36 mg/L). Urinanalysis showed leucocytes and many bacteria. Urinary tract infection was suspected; blood cultures and tests for tuberculosis were done.