Can you make the diagnosis?

Sally is having back pain, worse on the left side.  Throughout the day, it seems to worsen.  She also feels like she is getting the flu, and feels nauseated.  She takes some Advil thinking she pulled a muscle, but it doesn’t seem to help much.

Sally is otherwise a very healthy person.  She did have a bladder infection the prior week, and has a history of having her appendix removed.

Sally makes an appointment to see the doctor when she starts running a fever.

What is causing Sally’s back pain?

  1.  She has ruptured a disc in her back
  2.  Her gallbladder is acting up
  3.  Pneumonia
  4.  Kidney infection


If you guessed 4. a kidney infection, you are correct!

Kidney infections often start with a bladder infection.  If not treated early, or if the bacteria causing the infection is not sensitive to the antibiotic, it can worsen and spread to the kidney.  Kidney infections, also called pyelonephritis, cause symptoms including back pain, flu-like symptoms, fever, nausea and vomiting.

Kidney infections are serious, and if a patient has a kidney infection they must be seen right away for treatment.

A ruptured disc in the spine usually causes mid-line back pain and can send pain down the leg.  Gallbladder pain can cause back pain as well as abdominal pain, but it is usually on the right side.  Pneumonia can cause chest and back pain but is usually associated with a productive cough and often comes on after a cold.




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