Acute Pyelonephritis in Adults

被引:103
作者
Johnson, James R. [1 ,2 ]
Russo, Thomas A. [3 ,4 ]
机构
[1] Minneapolis Vet Affairs VA Hlth Care Syst, Minneapolis, MN USA
[2] Univ Minnesota, Minneapolis, MN USA
[3] Univ Buffalo State Univ New York, Buffalo, NY USA
[4] VA Western New York Hlth Care Syst, Buffalo, NY USA
基金
美国国家卫生研究院;
关键词
URINARY-TRACT-INFECTIONS; ACUTE UNCOMPLICATED PYELONEPHRITIS; DOUBLE-BLIND; TRIMETHOPRIM-SULFAMETHOXAZOLE; ANTIBIOTIC-TREATMENT; PRACTICE GUIDELINES; RANDOMIZED-TRIAL; BLOOD CULTURES; UNITED-STATES; CIPROFLOXACIN;
D O I
10.1056/NEJMcp1702758
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 degrees 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 mu mol per liter) (most recent measurement before presentation, 0.8 mg per deciliter [71 mu mol per liter]). Urinalysis is positive for leukocyte esterase and nitrites. How would you evaluate and manage this case?
引用
收藏
页码:48 / 59
页数:12
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