A woman in her late 70s on haemodialysis with type-2 diabetes and microscopic polyangiitis was admitted for treatment of a flare-up of vasculitis. One day, the patient developed abdominal pain and fever. Vital signs showed a body temperature of 39.0°, a blood pressure of 90/52 mm Hg and a heart rate of 118 beats/min. Tenderness was noted in the lower abdomen. Urinalysis showed red and white cell counts >50 per high power field, and gram-negative rods were detected in the urine by Gram …