讨论主治医师:本病例是一个发热、头痛、呕吐经多种抗生素治疗无效,而病情逐渐加重的病人,为了便于讨论,我们首先总结一下本病例的临床特点。医师甲:本病例有以下临床特点:1.老年,缓慢起病,病程较长。2.有发热、头痛、呕吐、腰痛、尿频、尿痛,经多种抗生素治疗,发热、头痛、呕吐逐渐加重。3.查体除慢性消耗病容外,有右肾区叩痛, Discussion attending physician: This case is a fever, headache, vomiting by a variety of antibiotic treatment ineffective, and the condition gradually aggravated patients, for the convenience of discussion, we first summarize the clinical features of this case. Physician A: The case has the following clinical features: 1. Elderly, slow onset, longer duration. 2. Fever, headache, vomiting, back pain, frequent urination, dysuria, after a variety of antibiotic treatment, fever, headache, vomiting gradually increased. 3. Physical examination in addition to chronic consumption of disease, the right kidney area percussion pain,