A patient with a ureteric stone and fever, rigors or raised inflammatory markers has an obstructed, infected kidney until proven otherwise. Antibiotics alone do not reach an obstructed system well.
Take blood and urine cultures, start intravenous antibiotics and arrange urgent decompression by ureteric stent or percutaneous nephrostomy. Definitive stone treatment waits until the infection has settled.
- Suspect an obstructed, infected kidney in any stone patient with fever.
- Take blood and urine cultures before starting antibiotics.
- Arrange urgent drainage by stent or nephrostomy alongside antibiotics.
- Delay definitive stone surgery until infection has resolved.
Why it matters
Obstructive pyelonephritis can progress to urosepsis within hours.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for urology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free