To the Editor.
—After having read the report concerning the adult respiratory distress syndrome (ARDS) in Gram-negative sepsis in the August 1979 Archives (139:867-869), we observed a case that can be discussed in relation to the problem raised by Kaplan et al—"whether the intravascular coagulation is the cause or the result of lung injury...."
Report of a Case.
—A 65-year-old man was admitted to Gemelli Polyclinic, Rome, because of hematuria. The year before he had undergone surgery of the prostate for adenoma. Since then, he has complained of episodes of relapsing hematuria, with urinary tract infections.On admission, an ECG, chest roentgenogram, 12-factor automated chemical analysis, hemoglobin level, RBC count, platelet count, WBC count with differential cell count, plasma fibrinogen level, partial thromboplastin time, and prothrombin time (PT) were normal.On the second day, he had fever and chills; cultures of blood, urine, and sputum were performed.On the sixth