A young woman with fever and low back pain

Clinical introduction A previously healthy, 20-year-old woman taking oral contraceptives presented to the Emergency Department (ED) with fever (body temperature, 39.2°C) and low back pain. Physical examination showed right costovertebral angle tenderness. Laboratory tests revealed elevated white blood cell count (13.2x109/L) and C-reactive protein level (9.75 mg/dL). Coagulation test results were unremarkable except for D-dimer level (1.5 μg/mL). Urinalysis results were normal. Abdominal CT with contrast was performed (figure 1). Question What is the most likely diagnosis?Renal infarction Acute focal bacterial nephritis Renal Abscess Antiphospholipid syndrome Answer: B Acute focal bacterial nephritis: Acute focal bacterial nephritis (AFBN), originally known as acute lobar nephritis,1 is an acute, localised, non-liquefactive bacterial infection speculated to be the midpoint in the spectrum of upper urinary tract infection from uncomplicated pyelonephritis to renal abscess.2 Symptoms suggestive of upper urinary tract infections,...
Source: Emergency Medicine Journal - Category: Emergency Medicine Authors: Tags: EMJ Image Challenge Source Type: research