Case 11-1981: A 74-Year-Old Woman with a Large, Nonfunctioning Kidney and Fever

Presentation of Case A 74-year-old woman was admitted to the hospital because of a radiologic abnormality of the left kidney. She was well until six weeks earlier, when she began to have an intermittent rise of the temperature to 38.3°C, accompanied by malaise, listlessness, and pain in the left flank. Five days before admission she entered another hospital. On examination she appeared well apart from overweight and mild pallor. A Grade 1 apical systolic murmur was heard. Abdominal, pelvic, and rectal examinations were negative. The urine was normal except that the sediment contained 12 white cells per high-power field. The . . .