A 66-year-old man presents with fever, rigors, left flank pain and vomiting. His temperature is 39.2°C, heart rate 110 beats/min and blood pressure 10...

Question

A 66-year-old man presents with fever, rigors, left flank pain and vomiting. His temperature is 39.2°C, heart rate 110 beats/min and blood pressure 104/64 mmHg. He has left costo-vertebral angle tenderness. Urine dipstick is positive for nitrites and leukocytes. What is the most appropriate management?

Accepted Answer

Admit for intravenous antibiotics for acute pyelonephritis

Answer

Treat with a 3-day course of Trimethoprim at home

Answer

Reassure and repeat dipstick in 1 week

Answer

Start topical antifungal therapy

Answer

Arrange routine outpatient urology review without antibiotics

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