Clinical QuickieInfectious Disease
Pyelonephritis
A kidney infection is more than a positive urinalysis.
Look for upper-tract features
Fever, flank pain/CVA tenderness, nausea/vomiting, and systemic symptoms distinguish pyelonephritis from uncomplicated cystitis.
Culture matters
Urine culture helps confirm the organism and susceptibility, particularly because resistance can change outpatient therapy.
Assess ability to stay outpatient
Hemodynamics, oral tolerance, pregnancy, obstruction risk, severe comorbidity, immunocompromise, and follow-up reliability affect disposition.
Think obstruction when the course is wrong
Stone plus infection, persistent fever, severe pain, or failure to improve may require imaging and source control.
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