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May 17, 1965

Lesion of Upper Pole of Right Kidney

JAMA. 1965;192(7):630-631. doi:10.1001/jama.1965.03080200048014

Dr. Luiz F. Mattoso: This was the first admission to the Massachusetts General Hospital of a 22-year-old woman with the chief complaints of dysuria and right flank pain of four days duration. During these four days she had noticed burning on urination, frequency, and nocturia, five to six times. The urine had a strong odor but was not bloody. On the day of admission she awoke at 4 AM with nausea, vomiting, and a dull, constant pain in the right flank. She was found to have costovertebral angle tenderness, a white blood cell count (WBC) of 14,800/cu mm, with 78% polymorphonuclear cells, and cloudy urine with 20 to 30 red blood cells and 50 to 70 white blood cells per highpowered field. It was felt that she had cystitis with early ascending pyelonephritis. Urine was obtained for culture, and she was sent home and told to take sulfisoxazole (Gantrisin) and

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