A 65-year-old man presented with a dull, aching pain in theleft lumbar region for three days duration. The pain wasaggravated by movement and associated with low grade feverand vomiting. He had a few episodes of passing out sandyparticles in his urine, several days prior to admission. Hedenied any lower urinary tract symptoms or alteration in hisbowel habits.Physical examination revealed stable haemodynamic status.His blood pressure was 130/70 mmHg with a pulse rate of96 beats/min. His body temperature was 37.6oC. He had mildtenderness in the left lumbar region on deep palpation of hisabdomen. Kidneys were not ballotable and renal punch wasnegative.