Relapsing oligosymptomatic fever in a kidney-pancreas transplant recipient

In summary, diagnosis of acute pyelonephritis may be very elusive after kidney transplantation and should be suspected in the presence of all fevers of unknown origin, even in the absence of apparent risk factors and of suggestive laboratory or standard radiological images. The fact that after a series of sophisticated laboratory and radiological procedures (Table 1), the first diagnostic evidence derived from the positivity of microscopic urinalysis, gives room to underline the importance of this simple and inexpensive test, too often considered as trivial and not used to its full potential. © ERA-EDTA 2004; all rights reserved.