Which symptom combination is most characteristic of pyelonephritis?

Which symptom combination is most characteristic of pyelonephritis?

• A. Urinary frequency and urgency
• B. Back and flank pain with CVA tenderness
• C. Dysuria
• D. Fever and chills

Answer: (B)

In pyelonephritis, the infection reaches the kidney itself, causing inflammation of the renal parenchyma. This leads to flank or back pain and a palpable or percussable tenderness over the costovertebral angle (CVA tenderness), which is a classic sign of kidney involvement. The CVA tenderness reflects the localized renal irritation and helps distinguish a kidney infection from a lower urinary tract infection. While fever and chills can occur with renal infections, they are nonspecific, and urinary frequency/urgency or dysuria are more typical of lower tract infections like cystitis. Thus, the combination of back/flank pain with CVA tenderness best characterizes pyelonephritis.

In pyelonephritis, the infection reaches the kidney itself, causing inflammation of the renal parenchyma. This leads to flank or back pain and a palpable or percussable tenderness over the costovertebral angle (CVA tenderness), which is a classic sign of kidney involvement. The CVA tenderness reflects the localized renal irritation and helps distinguish a kidney infection from a lower urinary tract infection. While fever and chills can occur with renal infections, they are nonspecific, and urinary frequency/urgency or dysuria are more typical of lower tract infections like cystitis. Thus, the combination of back/flank pain with CVA tenderness best characterizes pyelonephritis.