Cindy is a 21-year-old college student who presented to urgent care several days ago with complaints of fever, chills, and flank pain. She also complains of urinary frequency urgency, and dysuria. Physical exam showed costovertebral tenderness. UA showed white blood cell casts. A urine culture was performed and the patient was started on broad-spectrum antibiotics. She was instructed to drink

lots of fluids and to take acetaminophen or ibuprofen for pain. She was also instructed to take all the antibiotics, even if she started to feel better. She returns today because she is still not feeling well and is continuing to run a fever. A check of the urine culture run several days previous shows the infectious organism is E. coli. A different antibiotic was prescribed. The patient was once again told to push fluids, and use OTC pain relievers if needed. She was also instructed to return in three days to make sure the new antibiotic is working.

Dx. Pyelonephritis due to E. coli

First-listed diagnosis: ________
Secondary diagnoses: ________
Fill in the blank with correct word.

First-listed diagnosis: ________
Answer: Acute pyelonephritis – N10

Secondary diagnoses: ________
Answer: E. coli infection – B96.20