[Acute hemorrhagic cystitis following chlordimeform poisoning ]

A 19-year-old and a 50-year-old man who together had cleaned a water-tank as part of their duties in a tank protection and cleaning firm developed that same evening lower abdominal pain, dysuria and haematuria. Cystoscopy revealed haemorrhagic cystitis in both patients, a finding confirmed by bladder mucosa biopsy. 4-chlor-2 methylaniline (concentration less than 1 mg/l) was found in hydrolysed serum of both. This metabolite of the pesticide chlordimeform was also found in the urine of the 51-year-old patient (16 mg/l). The haematuria regressed within two days of the patients having increased their fluid intake. Dysuria improved within a week. It is likely that chlordimeform had previously been transported in the water-tank. In case of haemorrhagic cystitis possibly caused by occupational or other poisoning, serum and urine should always be obtained for toxicological tests.