Archivos españoles de urología
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The diagnosis of acute pyelonephritis (APN) is based fundamentally on the clinical and bacteriological findings. Radiology is useful in ruling out obstructive causes that often require surgical management. The present study analyzed the role of renal ultrasonography (US) in patients with clinical symptoms, signs and history compatible with APN that have normal plain abdominal x-rays. ⋯ In our series, renal US evaluation indicated surgical treatment in 5.8% of patients with clinical features of APN and a plain abdominal x-ray with no evidence of lithiasis. This incidence is likely to be lower in the outpatient setting. It is difficult to propose a standard approach in the management of these patients. It may therefore be more reasonable to utilize US and IVP in those patients who do not respond to antibiotic therapy.