A 40-year-old woman on ICU is being treated for urosepsis from an obstructed infected kidney stone. She received piperacillin/tazobactam and a ureteri...

Question

A 40-year-old woman on ICU is being treated for urosepsis from an obstructed infected kidney stone. She received piperacillin/tazobactam and a ureteric stent was placed. Despite antibiotics and source control, she remains febrile on day 4 with persistently elevated inflammatory markers. Repeat urine and blood cultures are negative. What is the most important next step?

Accepted Answer

Perform CT abdomen to assess for residual obstruction, perinephric abscess, or other complications

Answer

Broaden antibiotics to meropenem empirically

Answer

Add antifungal therapy empirically

Answer

Stop antibiotics as cultures are negative

Answer

Commence IV hydrocortisone for presumed CIRCI

uk-fficm MCQ (SBA): Failure to Improve - Source Control Reassessment