Which condition is characterized by fever and flank tenderness due to bacterial infection of the kidney?

Which condition is characterized by fever and flank tenderness due to bacterial infection of the kidney?

• A. Mittelschmerz
• B. Ectopic Pregnancy
• C. Malloy-Weiss syndrome
• D. Pyelonephritis

Answer: (D)

Fever with flank tenderness points to infection of the kidney, i.e., pyelonephritis. When bacteria ascend from the bladder or spread to the renal parenchyma, the result is an upper urinary tract infection that classically presents with systemic fever and localized pain over the costovertebral angle or flank. Additional symptoms may include nausea, vomiting, and urinary changes, but the key clue is the combination of fever and flank tenderness signaling kidney involvement. Mittelschmerz is mid-cycle ovulatory pain without fever or flank tenderness. An ectopic pregnancy presents with abdominal pain and vaginal bleeding and may have a positive pregnancy test, but fever with flank tenderness is not its hallmark. Mallory-Weiss syndrome involves a GI bleed from a tear at the gastroesophageal junction after retching, not kidney infection.

Fever with flank tenderness points to infection of the kidney, i.e., pyelonephritis. When bacteria ascend from the bladder or spread to the renal parenchyma, the result is an upper urinary tract infection that classically presents with systemic fever and localized pain over the costovertebral angle or flank. Additional symptoms may include nausea, vomiting, and urinary changes, but the key clue is the combination of fever and flank tenderness signaling kidney involvement.

Mittelschmerz is mid-cycle ovulatory pain without fever or flank tenderness. An ectopic pregnancy presents with abdominal pain and vaginal bleeding and may have a positive pregnancy test, but fever with flank tenderness is not its hallmark. Mallory-Weiss syndrome involves a GI bleed from a tear at the gastroesophageal junction after retching, not kidney infection.