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Pediatric pyelonephritis — USMLE Step 3 MCQ

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ModeratePediatrics (well-child, chronic management)Pediatric pyelonephritisUSMLE Step 3

A 5-year-old child has fever, dysuria, and flank pain. Urinalysis shows pyuria and nitrites. He is vomiting and appears dehydrated. Which of the following is the most appropriate at this time?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Admit for intravenous antibiotics and hydration

Febrile UTI or pyelonephritis with vomiting and dehydration requires parenteral therapy and hydration.

Reference: AAP urinary tract infection guidance; IDSA antimicrobial guidance