Case Presentation: A 32-year-old woman with history of recurrent urinary tract infections (UTI) presented with malaise and dysuria. Vitals were notable for low grade fever, tachycardia, and hypotension (85/50). Physical exam with 2+ pitting edema and bilateral costovertebral angle tenderness. The white blood cell count was 23,000 cubic mm, creatinine 6.4 mg/dL (baseline 0.6 mg/dL), [...]