Differential Diagnosis for Lower Pole Kidney Stone and Fever

• Single most likely diagnosis
  • Pyelonephritis: This is the most likely diagnosis because a kidney stone can obstruct the flow of urine, leading to an infection in the kidney, which is known as pyelonephritis. The presence of a fever supports the diagnosis of an infection.
• Other Likely diagnoses
  • Ureteropelvic junction obstruction with infection: If the stone is causing an obstruction at the junction where the ureter meets the pelvis of the kidney, it could lead to an infection.
  • Cystitis with secondary infection of the kidney stone: Although less common, if the stone is causing irritation or obstruction, it could lead to a urinary tract infection (UTI) that ascends to the kidney.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Sepsis due to urinary tract infection: If the infection is not properly treated, it could lead to sepsis, a life-threatening condition.
  • Xanthogranulomatous pyelonephritis: A rare but serious infection of the kidney that can occur in the presence of a long-standing obstruction, such as a kidney stone.
  • Emphysematous pyelonephritis: A severe infection of the kidney that involves gas formation in the kidney tissue, often seen in diabetic patients.
• Rare diagnoses
  • Renal tuberculosis: Although rare in many parts of the world, renal tuberculosis can present with symptoms similar to those of a kidney stone and infection.
  • Malacoplakia: A rare inflammatory condition that can affect the urinary tract and present with symptoms similar to those of a kidney infection.