(Disclaimer: This article is only for scientific purposes, in order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: The patient came to our outpatient clinic due to recurrent fever for about 1 month, and underwent ultrasound-guided left nephron puncture and drainage due to bilateral ureteral stenosis with severe hydronephrosis in both kidneys half a year ago, and the patient did not change the fistula tube in a timely manner after the operation. After examination, the patient was considered to have fever caused by urinary tract infection, and agreed to be hospitalized after communication with the patient. After 10 days of anti-infection treatment and replacement of the left nephrostomy tube, the patient’s body temperature gradually returned to normal, and the drainage fluid from the left nephrostomy tube gradually turned clear. Basic information] Male, 57 years old [Disease type] Urological tract infection [Hospital] Union Hospital of Fujian Medical University [Date of consultation] June 2022 [Treatment plan] Medication (Ertapenem for injection, Ceftazidime for injection) + replacement of left nephrostomy tube [Treatment cycle] Hospitalization for 10 days, outpatient follow-up after 1 week [Effect of treatment] Gradual return of body temperature to normal, and gradual clearing of drainage fluid from the left nephrostomy tube. The patient is a middle-aged male, who came to our outpatient clinic because of recurrent fever for about 1 month. Half a year ago, he underwent ultrasound-guided left nephron puncture and drainage for bilateral ureteral stenosis with severe hydronephrosis in both kidneys, and he was advised to undergo regular outpatient checkups and replacement of fistula tubes after the operation, but he did not follow up the consultation on time after discharge from the hospital. At the time of this visit, his temperature reached 39℃, and there was purulent fluid in the left nephrostomy, CT suggested that the nephrostomy tube was in place, and the drainage was still smooth, and he was considered to have fever caused by urinary tract infection, so he agreed to be hospitalized after communicating with the patient. After the hospitalization, we improved the routine blood test, PCT, CRP, renal function, coagulation, biochemistry, urine routine, urine bacterial culture in nephrostomy tube, drug sensitivity, etc. We firstly gave the empirical anti-infective drug ceftazidime for injection to deal with the anti-infective treatment, and then the patient still had recurring fever, and the highest body temperature was 38.5℃. Urine bacterial culture results confirmed that Escherichia coli infection, and there are a number of drug resistance, so according to the results of drug sensitivity to select sensitive antibiotics injection Ertapenem, anti-infective treatment, and replacement of the left nephrostomy tube. 3 days to review the blood, urine routine indicators, are compared with the previous gradual improvement of the new left nephrostomy tube drainage is smooth, the drainage fluid gradually turned clear. The patient was discharged after 10 days of hospitalization, and was asked to be rechecked after 1 week. The patient was admitted to the hospital and given empirical antibiotic treatment. Although there was still fever, the maximum body temperature was lower than that before admission. The urine in the left nephrostomy tube was taken for bacterial culture and drug sensitivity test. Through the targeted use of sensitive antibiotics and timely replacement of the left nephrostomy tube, the patient’s body temperature gradually returned to normal, and the patient did not have fever for 3 consecutive days, and the drainage fluid of the left nephrostomy tube gradually turned clear. Fourth, precautions Through the treatment of the patient’s condition has been relieved, for the patient is happy. Because the patient has long-term urinary tube, especially percutaneous external renal drainage tube, especially pay attention to local clean care, to avoid external bacteria invasion caused by infection. Nephrostomy tubes need to be replaced regularly, if there is poor drainage or there is already a clearer infection of the tube lumen, they need to be replaced in time to avoid causing recurrent infections. Urological tube is a high-risk factor for urinary tract infection, if it needs to be retained for a long period of time, it should be paid attention to regular outpatient follow-up, including blood and urine routine review. Usually pay attention to the care of the drainage tube, do not pull the tube when moving. Fifth, personal perception Urinary tract infection is a common disease in urology, this case of patients with long-term nephrostomy, and do not pay attention to the care of the tube, not replaced on time, caused by urinary tract infection. Therefore, in clinical work, we must emphasize the importance of tube care to patients and their families, including local cleaning and dressing change and regular replacement of nephrostomy tube. This case also reminds us that the use of antibiotics need to have a clear indication, do not use indiscriminately, do not abuse, according to the drug sensitivity test to select the most sensitive antibiotics, targeted treatment can play a better effect.