An unusual cause of low back pain in a patient with sepsis.

A 61-year-old male with type II, insulin-dependent diabetes mellitus with poor control, came in for progressive low-back pain and persistent fever associated with dysuria. For the past 3 days, he had been taking oral amoxicillin plus clavulanic acid due to a suspected urinary tract infection. During the physical examination, there was notable pain in the right renal fossa with positive kidney punch. The basic analysis showed leukocytosis of 18,300 × 10e9/l with neutrophilia of 92.3%, elevated lactate (2.7 mmol/l), procalcitonin (11.57 ng/ml) and fibrinogen (703 mg/dl). Urine sediment showed no bacteriuria or leukocyturia. An emergency abdominal ultrasound was performed with no pathologically significant findings.