UTI
59
A 64-year-old female presents to the emergency department with dysuria, right-sided back pain, fever, and vomiting. She reports a 3-day history of worsening symptoms, including burning with urination, chills with shaking, nausea, and multiple episodes of vomiting. For several days, she has noticed cloudy, foul-smelling urine and initially thought she had the flu. She became concerned when the pain migrated to her back and she was no longer able to keep down fluids. She denies hematuria and vaginal discharge. She has tried increasing her water intake and taking cranberry supplements without improvement.