<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 45-year-old woman presents with fever, chills, nausea, and dysuria. She says her symptoms started 4 days ago and have progressively worsened. Her past medical history is significant for recurrent UTIs for the past 6 months and for diabetes mellitus type 2, diagnosed 5 years ago and treated with metformin. Her vital signs include: temperature 39.5C 103.1F, blood pressure 10070 mm Hg, pulse 90min, and respiratory rate 23min. On physical examination, moderate right costovertebral angle tenderness is noted. Laboratory findings are significant for the following:WBC 9,500mm3RBC 4.20 x 106mm3Hematocrit 41.5Hemoglobin 13.0 gdLPlatelet count 225,000mm3Urinalysis:Color Dark yellowClarity TurbidpH 5.5Specific gravity 1.021Glucose NoneKetones NoneNitrites PositiveLeukocyte esterase PositiveBilirubin NegativeUrobilirubin 0.6 mgdLProtein TraceBlood NoneWBC 25hpfBacteria ManyUrine culture and sensitivities are pending. Which of the following is the best next step in the management of this patient?? A: Contrast MRI of the abdomen and pelvis, B: Discharge with outpatient antibiotic therapy, C: Admit for prompt percutaneous nephrostomy, D: Renal ultrasound, E: Admit for IV antibiotic therapy,  <response>: This is a patient with symptoms and findings consistent with acute pyelonephritis, including fever, chills, nausea, dysuria, costovertebral angle tenderness, leukocytosis, and pyuria with bacteriuria on urinalysis. She has a history of recurrent UTIs and diabetes, putting her at increased risk. The question asks for the best next step in management. Choice A, contrast MRI, is unnecessary at this point. Choice B, outpatient antibiotics, would be insufficient given her sepsis. Choice C, nephrostomy, is too aggressive as a first step. Choice D, renal ultrasound, could be useful for evaluating hydronephrosis but does not address the need for inpatient treatment. Choice E, admitting the patient for IV antibiotics, is the best option. She requires inpatient management with IV antibiotics and fluid resuscitation for sepsis secondary to acute pyelonephritis.E: Admit for IV antibiotic therapy 