Case history
Case history
A 34-year-old woman who is otherwise healthy has had a fever, nausea, and right-sided back pain for 2 days. The physical exam shows a temperature of 102.2ºF (39.0ºC), blood pressure of 120/60, pulse of 110, respiratory rate of 18, and right-sided costovertebral angle tenderness to percussion. Dipstick urinalysis is positive for leukocytes, nitrites, and blood.
Other presentations
Older patients often present with nonspecific complaints. Patients with illness causing immunosuppression (e.g., diabetes mellitus) may be at higher risk of developing bacteriuria and resulting pyelonephritis. Older men may be more likely to have urinary tract infections as a result of abnormalities such as obstruction with benign prostatic hyperplasia, incomplete voiding, and decreased antibacterial effect of prostatic fluids.[2]
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