A 26-year-old sexually active woman presents with a six-day history of fevers, chills, dysuria, frequency, and flank pain. She also reports nausea and has repeatedly vomited and has been unable to maintain oral intake.
Her past medical history is remarkable only for the normal vaginal delivery of a daughter three years ago. She states that she is not currently pregnant.
Physical examination is otherwise remarkable for costovertebral angle tenderness to palpation on the left side.
Vitals:
• [Recumbent] BP: 98/66
• [Recumbent] HR: 88
• [Standing] BP: 88/55
• [Standing] HR: 101
• Temp: 38.7 °C
• RR: 13
Laboratory analysis shows:
• Peripheral blood leukocyte count: 26,200 cells/mm3 with 82% neutrophils and 15% band forms
• Electrolytes: Within normal limits
• Glucose: 93 md/dL
• Urine Sample shows: Pyuria and >100,000 bacteria
- What is your diagnosis? Explain.
- Is this a “complicated” or “uncomplicated” infection? Explain.
- What is your treatment plan for the patient?