Which group of symptoms is indicative of pyelonephritis?

Pyelonephritis is an upper urinary tract infection that typically presents with a specific set of symptoms. The most indicative symptoms of pyelonephritis include fever, flank pain, and costovertebral angle tenderness.

Fever suggests a systemic response to infection, while flank pain often indicates irritation of the kidney or surrounding structures due to inflammation. Costovertebral angle tenderness, which can be assessed by gently tapping on the back at the rib-vertebra junction, is also a classic sign of kidney inflammation and infection. Together, these symptoms strongly point to pyelonephritis and help differentiate it from lower urinary tract infections, which primarily cause dysuria and hematuria.

The other symptoms associated with the other choices do not specifically indicate pyelonephritis. Dysuria and hematuria primarily suggest a lower urinary tract infection, nausea, vomiting, and diarrhea could indicate a gastrointestinal issue, and headache, fatigue, and malaise are nonspecific and can be seen in many different conditions. Thus, the combination of fever, flank pain, and costovertebral angle tenderness is key in diagnosing pyelonephritis.