Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with high-grade fever, rigors, and persistent unilateral flank pain. Symptoms associated with dysuria, urgency, and malaise. History significant for recurrent UTIs, nephrolithiasis, or uncontrolled diabetes mellitus. No history of recent urological instrumentation or trauma.
Clinical Examination Findings
Vitals: Febrile (T > 38.5°C), tachycardic. Abdominal exam: Positive costovertebral angle (CVA) tenderness on the affected side. Palpable mass may be present in thin patients. Bowel sounds present. No signs of generalized peritonitis.
Treatment Protocol
Initiate broad-spectrum IV antibiotics (e.g., Carbapenems or Piperacillin/Tazobactam) pending culture results. Imaging-guided percutaneous drainage (pigtail catheter placement) indicated for abscesses > 3-5 cm. Monitor renal function and inflammatory markers (CRP/ESR). Surgical debridement or nephrectomy reserved for refractory cases.