A 29 year old woman presents with fever, chills, nausea, and left flank pain. She has a history of recurrent urinary tract infections. Temperature is 39.1 C and costovertebral angle tenderness is present. Urinalysis shows white blood cell casts and positive leukocyte esterase. Which of the following is the most likely diagnosis?
- A)Cystitis
- B)Nephrolithiasis
- C)Acute pyelonephritisGABARITO
- D)Minimal change disease
- E)Renal artery stenosis
Explicação
Acute pyelonephritis is correct. Fever, flank pain, costovertebral angle tenderness, and white blood cell casts indicate infection that has ascended to involve the renal parenchyma. White cell casts localize inflammation to the kidney rather than the bladder. Ver explicação completa e trilha adaptativa →