{"ops":[{"insert":"A 64 year old lady presents with dysuria, suprapubic pain, and nausea and vomiting for 3 days. She also complains of right flank pain and fever since yesterday.\n\nShe has been on treatment for diabetes and hypertension for the last 8 years, with poor control, and is currently on insulin, losartan and amlodipine. She had temporarily stopped insulin for the last 3 days, given her reduced food intake.\n\nShe also underwent extracorporeal shock wave lithotripsy for recurrent renal calculi last year. A complete blood count is significant for a leukocyte count of 12,500\/mm3, while a random plasma glucose level is 917 mg\/dL.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-073_en.png"}},{"insert":"\n"}]}