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Infected obstructing ureteral stone — ABEM Board MCQ

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HardRenal/Metabolic emergenciesInfected obstructing ureteral stoneABEM Board

A 45-year-old man arrives as ESI 2 with sudden severe flank pain radiating to the groin. Temperature is 38.7 C, BP 96/58, HR 122, creatinine is 2.1 mg/dL, urinalysis shows pyuria and hematuria, and CT shows a 7-mm proximal ureteral stone with hydronephrosis. Which of the following is the most appropriate disposition?

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

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Correct answer: C — Admission for IV antibiotics and urgent urologic decompression

An infected obstructing stone requires admission, IV antibiotics, and urgent drainage with urology or interventional radiology.

Reference: AUA ureteral calculi guidance; Surviving Sepsis Campaign