Haematuria associated with ureaplasma infection in sickle-cell trait

Phase-contrast microscopy of the urine of a young Greek woman with macroscopic haematuria showed sickling of the red blood cells. The diagnosis of sickle-cell trait was confirmed with haemoglobin electrophoresis, and an intravenous pyelogram demonstrated the typical medullary cavities seen in this disease. Urine collected from the left ureter, from which the haematuria originated, grew 10(6) Ureaplasma urealyticum/ml. With Doxycycline therapy the macroscopic haematuria and the sickled cells in the urine resolved, but red cell casts and an excessive number of glomerular red blood cells persisted in the urine, confirming the presence of glomerulonephritis. Ureaplasma urealyticum has not previously been described in association with a sickling episode nor with the scarring of a sickle cell kidney. The possible role of this infection is discussed.