Acute pyelonephritis in adults

James R. Johnson, Thomas A. Russo

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


An otherwise healthy 35-year-old woman presents with urinary urgency, dysuria, fever, malaise, nausea, and flank pain. During a recent trip to India, she took a fluoroquinolone for diarrhea. On examination, the temperature is 38.6°C, the pulse 110 beats per minute, and the blood pressure 105/50 mm Hg; she has suprapubic and flank tenderness, without abdominal tenderness. The white-cell count is 16,500 per cubic millimeter, and the serum creatinine concentration 1.4 mg per deciliter (124 μmol per liter) (most recent measurement before presentation, 0.8 mg per deciliter [71 μmol per liter]). Urinalysis is positive for leukocyte esterase and nitrites. How would you evaluate and manage this case?

Original languageEnglish (US)
Pages (from-to)48-59
Number of pages12
JournalNew England Journal of Medicine
Issue number1
StatePublished - Jan 4 2018

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