Diagnosis is based on the history and examination, the finding of bacteria and pus cells in the urine, and growth of the organism. Note that, in the early stages, pus cells may not be excreted in the urine, as a result of the affected kidney 'shutting down'. Thus one negative MSU does not exclude the diagnosis.
Other possible investigations:
IVU (rarely used) - may reveal a temporarily non-functioning kidney on the affected side
Reference:
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