Renal and urinary tract masses Quiz: Ace Your Exams

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A 20-year-old man comes to the clinic due to burning urination for the past 3 weeks. The patient recently returned from a trip to Egypt, where he hiked and swam in freshwater. During that time, the patient developed an itchy rash over some parts of the body, which self-resolved after a few days. Medical history is unremarkable besides a gonorrhea infection 3 years ago, which was successfully treated with antibiotics. Vital signs are within normal limits. Physical examination shows no abnormalities. Complete blood count shows:  
 
 Laboratory value  Result  Reference range 
 Hemoglobin  12 g/dL  13.5-17.5 g/dL 
 Hematocrit  40%  41-53% 
 Platelet count  400,000/mm3  150,000-400,000/mm3 
 Leukocyte count  12,100/mm3  4,500-11,000/mm3 
 Neutrophils, segmented  54%  54-62% 
 Neutrophils, banded  5%  3-5% 
 Eosinophils  12%  1-3% 
 Basophils  0%  0-0.75% 
 Lymphocytes  25%  25-33% 
 Monocytes  7%  3-7% 
   
Urine sample is obtained and the specimen under light microscopy reveals parasites, as shown below:  



Reproduced from: Wikimedia Commons

If left untreated, this patient is most likely to develop which of the following complications? 

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