au-amc MCQ (SBA): Pyelonephritis indications for admission

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MediumInfectious DiseasesPyelonephritis indications for admissionau-amc

A 45 year old woman presents with high fever, flank pain and rigors. She is tachycardic and has costovertebral angle tenderness on examination. Urinalysis shows leucocytes and nitrites. Which of the following features would most strongly support admission to hospital rather than outpatient management?

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