A 67-year-old woman presents with fever, flank pain and rigors. She is hypotensive (BP 90/50 mmHg), tachycardic and has costovertebral angle tendernes...

Question

A 67-year-old woman presents with fever, flank pain and rigors. She is hypotensive (BP 90/50 mmHg), tachycardic and has costovertebral angle tenderness. Urinalysis shows nitrites and leukocytes. What is the most appropriate management?

Accepted Answer

Admit for IV broad-spectrum antibiotics and fluid resuscitation

Answer

Treat as an outpatient with oral nitrofurantoin

Answer

Start cranberry juice and observe

Answer

Prescribe single-dose fosfomycin and discharge

Answer

No antibiotics unless a urine culture is positive

au-amc MCQ (SBA): Acute pyelonephritis and sepsis

A 67-year-old woman presents with fever, flank pain and rigors. She is hypotensive (BP 90/50 mmHg), tachycardic and has costovertebral angle tenderness. Urinalysis shows nitrites and leukocytes. What is the most appropriate management?