A 55-Year-Old Man Comes to the Emergency Department Because of Cramps

A 55-year-old man comes to the emergency department because of cramps and left-sided flank pain, nausea, and urinary frequency for 3 hours. He has no history of serious illness and takes no medications. He drinks 2-3 alcoholic beverages daily. Temperature is 39.2 C (102.6 F) , blood pressure is 90/50 mm Hg, pulse is 102/min, and respirations are 24/min. Examination of the back shows left costovertebral angle tenderness. The patient subsequently undergoes nephrectomy, and a cut section of the resected kidney is shown in the image below. Further evaluation of this patient would most likely reveal which of the following?

A) Escherichia coli infection
B) High urinary cystine excretion
C) Klebsiella infection
D) Parathyroid tumor
E) Persistently low urine pH

Correct Answer:

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