Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of high fever, shaking chills (rigors), dysuria, and severe right-sided flank pain. Nausea and vomiting began this morning. Reports dark, cloudy urine.
Clinical Examination Findings
Toxic appearing, flushed, and diaphoretic. Tachycardic (120 bpm) and hypotensive (90/60 mmHg), meeting SIRS criteria.
Treatment Protocol
Medical Emergency. Admit to medical ward/ICU. Draw blood cultures and urine culture stat. Initiate aggressive IV fluid resuscitation (30cc/kg bolus) and empiric broad-spectrum IV antibiotics (Ceftriaxone or Piperacillin-Tazobactam). Order Renal US to rule out obstructing stone.