Which systemic signs may indicate acute pyelonephritis in addition to normal UTI symptoms?

Acute pyelonephritis is a severe infection of the kidneys that commonly occurs as a complication of a urinary tract infection (UTI). While a typical UTI presents with localized symptoms such as dysuria, increased frequency, and urgency, acute pyelonephritis can manifest systemic signs that indicate a more severe infection.

The presence of WBC casts in the urine is a key laboratory finding associated with acute pyelonephritis. WBC casts are formed in the renal tubules and suggest that there is an inflammatory process within the kidney tissue, specifically related to a renal parenchymal infection. Along with this, fever and chills are hallmark systemic signs of pyelonephritis, indicating the body’s systemic response to infection. Fever suggests a significant inflammatory process, while chills can indicate a severe reaction, signaling that the infection may be affecting the overall system, not just localized to the urinary tract.

In contrast, the other choices do not wean the specific indicators associated with acute pyelonephritis. Hypotension and bradycardia are not common systemic responses in this condition. Chest pain and dyspnea may suggest alternative diagnoses such as pulmonary issues or cardiac events rather than renal infection. Similarly, bradycardia