A 33-year old woman presents with fever and right-sided flank pain for one day. There is no history of frequency, urgency, dysuria, or hematuria, and no bowel symptoms are present. Her medical history is unremarkable. A routine screening for diabetes, hypertension, and dyslipidemia performed last month was negative on all counts. Her surgical and gynecological histories are also unremarkable. Her last menstrual period was two weeks ago, and she is currently in a monogamous relationship. There is no history of sexually transmitted infections. She drinks socially and has never smoked.
Urinalysis: Pus cells: Field full RBC: 10-15/hpf WBC casts: Positive Leukocyte esterase test: Positive Urine Cultures: Results will be available in 48 to 72 hours
The ultrasound scan appears normal, with no imaging findings suggestive of calculi, ureteral obstruction, hydronephrosis, or abscesses.
BUN: 12 mg/dL (6 - 23) Creatinine: 0.79 mg/dL (0.6 - 1.0)
The CT scan shows no abnormalities of the kidneys, liver, gallbladder or pancreas.