[achistikbenny]

i think the patient has pyelonephritis-associated pili. she has ascending infection to the renal pelvis due to E COLI infection ,ie vesicoureteral reflux of urine .the suprapubic pain is due to cystitis and the flank pain,fever wbc cast etc...is due to pyelonephritis.so the virulence factor for e coli adherence to the uroepithelium is the p-pili.