A 42-year-old woman presents with fever, flank pain and vomiting. She has costovertebral angle tenderness and feels unwell. Urine dipstick is positive...

Question

A 42-year-old woman presents with fever, flank pain and vomiting. She has costovertebral angle tenderness and feels unwell. Urine dipstick is positive for nitrites and leucocytes. What is the most appropriate initial management?

Accepted Answer

Admit for intravenous antibiotics

Answer

Treat with a 3-day course of trimethoprim at home

Answer

Offer simple analgesia only and review if not better in 1 week

Answer

Arrange urgent renal ultrasound before treatment

Answer

Prescribe topical oestrogen cream

uk-plab-1 MCQ (SBA): Acute pyelonephritis

A 42-year-old woman presents with fever, flank pain and vomiting. She has costovertebral angle tenderness and feels unwell. Urine dipstick is positive for nitrites and leucocytes. What is the most appropriate initial management?