Diffuse alveolar infiltrates and macroscopic hematuria: a run-and-gun affair.

mg/l and 70 mm/h, respectively). Plasma creatinine was 1.3 mg/dl and the urea was 74 mg/dl. The 24-hour urine output was 3,100 ml with a glomerular filtration rate of 65 ml/min/1.73 m 2 . Urine antigen tests for Legionella pneumophila and Streptococcus pneumoniae were negative. Chest X-ray revealed bilateral diffuse alveolar infiltrates ( fig. 1 ). Respiratory tract infection was suspected and empiric antimicrobial treatment was started with a fluoroquinolone (moxifloxacin). A pharyngeal swab was obtained and a prompt urinalysis showed proteinuria at 600 mg/24 h, hematuria with a large number of dysmorphic red blood cells and several red-cell casts. A few hours later, a pulmonary function testing revealed a FEV 1 of 2.4 l (64.7% of predicted), FVC of 3.4 l (69.0% of predicted), FEV 1 /FVC ratio of 77.1%, total lung capacity of 5.5 l (76.3% of predicted) and diffusing capacity for carCase Report