| Cause | Evaluation |
|---|---|
| Infectious causes | |
| Perinephric abscess | Ultrasound; CT |
| Renal tuberculosis | Urine TB culture and PCR |
| Fungal infections of the kidneys | Gram stain; fungal culture |
| Partially treated pyelonephritis | History; CT |
| Fungal infections of the bladder | Gram stain; fungal culture |
| Partially treated cystitis | History |
| Contamination of urine with antiseptic | Repeat urinalysis |
| Prostatitis | Prostate exam |
| Urethritis | History; urine PCR; chlamydia culture |
| Cervicitis | Vaginal exam; cervical culture |
| Vaginitis | Vaginal exam; wet prep/KOH |
| Appendicitis, diverticulitis | US; CT |
| Q fever | History; serology |
| Noninfectious causes | |
| Crystal nephropathy and nephrolithiasis | CT, IVP |
| Lithium or heavy metal nephropathy | History; lithium level; heavy metal tests |
| Renal papillary necrosis (diabetes, sickle cell disease, analgesic nephropathy) | |
| Renal sarcoidosis | Urinalysis, IVP; US; CT |
| Polycystic kidney disease | Renal biopsy |
| Renal transplant rejection | US; CT |
| Interstitial nephritis | History; renal biopsy |
| Genitourinary malignancy | Urine eosinophils, renal biopsy |
| Interstitial cystitis | CT; cystoscopy |
| Systemic lupus erythematosis, other autoimmune diseases | Cystoscopy |
| Kawasaki disease | ESR; ANA, anti-DNA |
| History; physical exam |
ANA, antinuclear antibodies; CT, computed tomography; ESR, erythrocyte sedimentation rate; KOH, potassium hydroxide; IVP, intravenous pyelogram; PCR, polymerase chain reaction; TB, tuberculosis; US, ultrasound.