To distinguish Pyelo (i.e. Infection) from a Kidney Stone:
- Fever strongly suggests Pyelo
- Flank &/or CVA tenderness suggest Pyelo
- Very abrupt onset suggests Stone
- Recurrent wave-like paroxysms of pain, lasting around 20 minutes, suggest Stone.
- Kidney Stone pain radiates to groin / genitals
- History of prior episodes suggests Stone
Findings on Dipstick Urinalysis:
Leukocyte Esterase:- Negative = Definitely NOT Pyelo
- Positive = could be either Pyelo or Stone
- Positive = Likely Pyelo (OR very Contaminated Specimen)
- Negative = Could be Pyelo with low colony count, OR no UTI
- Negative = speaks against Stone (not for sure, though)
- Positive = Stone (if leukocyte esterase is Neg) OR menses
- Very Low (<1.005) = suspect false-negative leukocyte esterase / nitrites
- maybe with enormous struvite staghorn stone
See posting Abdominal Pain – 2.