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Question 283 · LEK · Urinary tract infections

A 29-year-old female patient came to the emergency department because of abdominal pain, high fever up to 40°C with chills and nausea. Laboratory test showed CRP 120 mg/L (N<5 mg/L), leucocytes 16 G/L, and the following results of urinalysis: specific gravity 1.030 g/mL; protein - 1.2 g/L; leucocytes 30-50 per HPF + numerous leucocytes in packs; intact erythrocytes 10-20 per HPF. The most probable diagnosis in this patient is:

  1. A. acute glomerulonephritis.
  2. B. chronic glomerulonephritis.
  3. C. bladder infection.
  4. D. acute pyelonephritis.
  5. E. systemic lupus erythematosus.
Hint

Weigh the severity of systemic signs (fever with chills, high CRP, leukocytosis) and the pyuria against what a lower UTI or glomerular disease would produce.

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