Which findings are most consistent with acute pyelonephritis?

Which findings are most consistent with acute pyelonephritis?

• A. Hypertension and costovertebral angle tenderness
• B. Increased blood urea nitrogen and fatigue
• C. Decreased serum creatinine and chills
• D. Leukocytosis and flank pain

Answer: (D)

Acute pyelonephritis is a kidney infection that causes both a systemic inflammatory response and kidney-specific pain. The most characteristic findings are fever or chills, flank pain, and costovertebral angle tenderness, with leukocytosis reflecting the infectious process. The combination of leukocytosis with flank pain best captures the body’s infection response plus kidney involvement, making it the most consistent choice for this condition. Hypertension isn’t typically an acute sign here, and changes in kidney function tests like decreased creatinine or isolated BUN shifts aren’t as specific to this scenario.

Acute pyelonephritis is a kidney infection that causes both a systemic inflammatory response and kidney-specific pain. The most characteristic findings are fever or chills, flank pain, and costovertebral angle tenderness, with leukocytosis reflecting the infectious process. The combination of leukocytosis with flank pain best captures the body’s infection response plus kidney involvement, making it the most consistent choice for this condition. Hypertension isn’t typically an acute sign here, and changes in kidney function tests like decreased creatinine or isolated BUN shifts aren’t as specific to this scenario.