No abstract

Because of the rarity of anaerobic infections of the urinary tract and the difficulty of establishing these organisms as pathogens, anaerobic culture is not included as part of routine urine bacteriological examination. Pyuria was found during examination of a 41-year-old man with a chronic renal allograft rejection reaction. Aerobic urine cultures failed to yield any pathogens. Urine cytology demonstrated intracellular organisms that proved to be Fusobacterium nucleatum on anaerobic culture. The serotypically identical organism was isolated from a needle biopsy specimen of the renal allograft. In the presence of pyuria the finding of micro-organisms in the urine sediment that fail to grow on routine aerobic cultures should lead to examination for anaerobic bacterial infection of the urinary tract.

Renal biopsies were performed on 18 patients afflicted with moderately severe or severe rheumatoid arthritis ranging from 20 to 58 years in age and with minimal to mild urine abnormalities. No abnormality was found in 11 cases. Seven biopsies revealed minimal increase in mesangial cells and matrix on light microscopy with focal tubular atrophy in some. Electron microscopy showed slight increase in mesangium, presence of ‘deposits’ in the latter and epithelial cells and fusion of podocytes in several places. Microtubular structures were found in one case. Immunofluorescent studies were negative in all cases.