Figure 733

Histologic appearance of pyelonephritic kidney. A, The renal tissue is severely edematous and interspersed with inflammatory cells and hemorrhagic streaks. B, On another section, severe inflammation, comprising a majority of polymorphonuclear leukocytes, induces tubular destruction and is accompanied by a typical infectious cast in a tubular lumen (arrow).

Clinical picture compatible with acute pyelonephritis (APN)

Positive

Clinical picture compatible with acute pyelonephritis (APN)

Positive

Plain abdominal radiograph Ultrasonography

Primary APN Drug therapy only

Start treatment with first-line antibiotics

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