Abordaje diagnóstico de pielonefritis litiásica en paciente masculino adulto: enfoque en imágenes diagnósticas y estudios de laboratorio. A propósito de un caso.

The coexistence of pyelonephritis and renal lithiasis, although rare in men, represents a significant medical challenge, often associated with complicated urinary tract infections in the presence of obstructive stones, anatomical abnormalities, surgery or underlying diseases. Escherichia coli remains the predominant pathogen, although other microorganisms also play an important role. Initial diagnosis includes a thorough analysis of clinical symptoms such as fever, low back pain and dysuria, accompanied by laboratory tests and imaging techniques. Ultrasonography is a useful initial tool, although limited in sensitivity, while multidetector computed tomography (CT) is the imaging technique of choice to assess disease severity. Innovations such as dual-energy CT have improved the chemical characterization of stones, optimizing personalized treatment. Comprehensive management requires antibiotics, intervention to relieve obstruction and long-term preventive strategies such as dietary modifications and metabolic control. This multidisciplinary approach not only improves clinical outcomes, but also reduces the risk of recurrences and serious complications such as sepsis or renal failure.