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Clinical Impression

Clinical Impression. Acute pyelonephritis with concomitant community-acquired pneumonia vs. pulmonary tuberculosis reactivation . Acute Uncomplicated Pyelonephritis. fever (>38⁰C) chills flank pain cost vertebral angle tenderness nausea and vomiting

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Clinical Impression

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  1. Clinical Impression Acute pyelonephritis with concomitant community-acquired pneumonia vs. pulmonary tuberculosis reactivation

  2. Acute Uncomplicated Pyelonephritis • fever (>38⁰C) • chills • flank pain • cost vertebral angle tenderness • nausea and vomiting • with or without signs and symptoms of lower urinary tract infection (dysuria, frequency, urgency and hematuria) in an otherwise healthy female • with no clinical or historical evidence of structural or functional urologic abnormalities • Laboratory findings include pyuria (> 5 wbc/hpf of centrifuged urine) and bacteriuria with counts of > 10,000 cfu of an uropathogen/ml in culture of voided urine The Philippine Clinical Practice Guideline on the Diagnosis and Management of Urinary Tract Infections: A Quick Reference Guide for Clinicians

  3. fever (38.6⁰C) • flank pain • chills • (+) CVA tenderness • 5 episodes of vomiting about ½ cup per episode • symptom of lower urinary tract infection (frequency) Acute pyelonephritis

  4. Pulmonary Tuberculosis Community-acquired Pneumonia (+) dyspnea (+) cough (+) colds (+) easy fatigability ↑tactile and vocal fremiti on the R upper lung Dullness to percussion on the R upper lung (+) fine crackles, bilateral R>L • (+) PTB, 2005 • chronic intermittent cough • easy fatigability

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