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Pediatrics
A 5-year-old girl without past history of UTI is in the hospital on antibiotics for E coli pyelonephritis. She is still febrile after 4 days of appropriate antibiotics. A renal ultrasound revealed no abscess, but a focal enlargement of one of the lobes of the right kidney. CT scan of the abdomen reveals a wedge-shaped area in the right kidney distinct from the normal tissue with minimal contrast enhancement. Appropriate management of this patient includes which of the following interventions?
Prolonged antibiotic therapy
Routine treatment with 10 to 14 days of antibiotics for pyelonephritis
Surgical consultation
Dimercaptosuccinicacid (DMSA) scan
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