Integrated Herbal Medicine Treatment for Acute Pyelonephritis: A Case Report

Introduction: Acute pyelonephritis typically requires 48-72 hours for fever resolution following appropriate antibiotic therapy, and prolonged hospitalization remains common. Integrative treatment combining antibiotics with Korean herbal medicines may enhance therapeutic outcomes through anti-inflammatory and immunomodulatory effects; however, systematic case reports on this approach remain limited.Case presentation: A 56-year-old female hospitalized for underlying conditions developed acute pyelonephritis with fever (38.7 ℃), flank pain, and pyuria. She received standard antibiotic therapy (oral levofloxacin 500 mg daily for 8 days) combined with Korean herbal medicine (Yongdamsagan-tang-hap-Soshiho-tang for 5 days, followed by Yongdamsagan-tang-hap-Jeoryeong-tang for 5 days). Fever normalized on the day of treatment initiation. By Day 3, white blood cell count decreased by 64.6%, neutrophil count decreased by 83.2%, and hs-CRP decreased by 63%; urinalysis findings normalized. The UTI-SIQ-8 score improved by 46.2% on Day 9. No adverse reactions were observed throughout treatment.Conclusion: This case demonstrates that Korean herbal medicine administered alongside standard antibiotic therapy was associated with favorable clinical response, including same-day fever resolution and significant improvement in inflammatory markers by Day 3 in acute pyelonephritis, without observed adverse effects.