Acute pyelonephritis

D: Good morning, Mr/Ms........I am doctor..........

What’s your name?

P: Good morning,I am..........

D: How old are you?

P: I am.........

D: What seems to be the problem?

P: I have got a fever with chill For three day

D: Do you have any other symptoms?

P: I have a pain when urination,it’s like burning.

D: what is the characteristic of your urine?

P: It’s cloudy and foul smell.

D: Do you have any back pain?

P: Yes, I have a right back pain.

D: Do you have any sand in your urine?

P: No,

D:Do you have any other symptom such as throwing up or diarrhea?

P: yes, I have throwing up 3 times yesterday but I have no diarrhea.

D: Ok, then I will ask about your personal information. What’s your job?

P: I’m officer,I’m busy all the day so I frequent hold my bladder.

D: Ok, Do you have any chronic disease?

P: No,I am healthy.

D: Are there you take any medication in the moment?

P: I just take a paracetamol when I have a headache but not frequent doctor.

D: Are you allergic to any medication?

P: No
D:ok, then I will check your body. First I will check your V/S
I will put the thermometer in your armpit wait until it alarm. While waiting it complete I will check
your BP,RR,and PR, umm it’s normal but you have rapid pulse.Oh your temperature is 39.8 degree
celcius,You have a high grade fever.

D: Ok, then I will check your abdomen.I will palpate your abdomen please tell me if you have a pain.
It’s normal

D: Then I will check your back.Plese lie down on your left side on the couch,I will percuss your back.
Does it hurt?

P: Yes, it’s very hurt.

D: Does the pain radiate anywhere else?

P: No.

D: Ok we are finish now. There’s something wrong with your urinary tract.I think you might have a
acute pyelonephritis

P: what’s the cause of the disease?

D: This disease occur when the pathogen such as bacteria or virus travel up from your urethra to
kidney then it cause the inflammation result in your symptom include fever with chill, back pain,N/V
and pain when urinate,the character of your urine will change to cloudy and foul smell.

P: What are you doing to do about it?

D: First I will comfirm the diagnosis,I need to get your blood test for CBC and urine sample for
analysis. The nurse will collect your blood and urine sample,please waiting outside.
Ok.Ms......, the CBC has high WBC and your urine has high WBC too it’s confirm that you have a
bacterial infection in your urinary tract
So,You need to be hospitalizes.The treatment is IV antibiotic.I will give you an IV antibiotic until your
symptom is improved then I will switch to oral ATB until 7 day

P: OK doctor

D: Do you have any question?

P: No, thank you.

D: Ok ,please wait outside the nurse will bring you to admit.