<s>[INST] A 24-year-old recently post-partum female presents with lower back pain and fever to 101 degrees. She denies injuring her back and also denies any abdominal pain. She reports no urinary complaints or vaginal discharge.presence of significant tenderness at the junction between her posterior rib cage and her upper lumbar spine on the right side.Urinalysis dipstick performed in the office reveals specific gravity of 1.020, positive ketones, trace protein, large blood, positive nitrites, positive leukocyte esterase, TNTC white blood cells, and 4+ bacteria. [/INST] HiThanks for posting your query.      As per the description it seems like she is having urine infection which has spread to her kidney.      I advise to do ultrasound abdomen pelvis to confirm our diagnosis.      Also she needs to get Urine Culture sensitivity test which will help in guiding which antibiotic needs to be given. </s>