A 36-year-old man from Somalia was a refugee in Kenya that was able to come to the United States where he worked as a dishwasher

A 36-year-old man from Somalia was a refugee in Kenya that was able to come to the United States where he worked as a dishwasher with no health benefits. He came to a free clinic complaining of hematuria that occurred several times a week upon urination. The only symptom he complained of was right flank pain that began several years ago when he was injured in Kenya. The Doctor ordered a renal ultrasound, CBC, urinalysis and creatinine level. The CBC and creatinine levels were normal as was a urinalysis. The renal ultrasound showed nephrolithiasis (crystalized stones). A CT scan showed a thin rim of calcification of the right ureter and some calcification within the bladder. A cystoscopy (taking a camera up through the bladder) was performed and the Doctor noted areas that had a golden sheen in the bladder mucosa which could be consistent with a parasitic infection. A biopsy was performed which was sent to the lab. 2. Why didn’t the patient’s urinalysis indicate any blood when the patient was having hematuria?

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