Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of high-grade fever, rigors, and flank pain. Associated symptoms include dysuria, frequency, urgency, and occasional hematuria. No history of recent instrumentation or prior urological surgery. Systemic symptoms include nausea, vomiting, and malaise.
Clinical Examination Findings
Patient appears toxic/febrile. Vitals: Tachycardia, tachypnea, and fever >38.5°C. Abdominal exam: Positive unilateral or bilateral costovertebral angle (CVA) tenderness. Suprapubic tenderness may be present. Bowel sounds are present. No signs of peritonitis.
Treatment Protocol
Initiate empiric IV antibiotic therapy (e.g., Ceftriaxone or Fluoroquinolones) pending urine/blood culture results. Aggressive fluid resuscitation. Analgesics and antiemetics as needed. Monitor urine output and serial vitals. Consider imaging (CT KUB or Renal US) to rule out obstruction or abscess.