[Verified Answer]: A 2-year-old girl is brought to the…

Question: A 2-year-old girl is brought to the emergency department by her father because of a 1-day history of fever, chills, nausea, vomiting, and increased urinary frequency. Past Medical History: Treated for a lower urinary tract infection 6 months ago. Temperature: 39.5°C (103.1°F) Pulse: 104/min Respirations: 20/min Physical Examination: Bilateral flank tenderness Laboratory Studies: TestResultLeukocyte count28,400/mm3Segmented neutrophils86%Bands12%Lymphocytes2%Platelet count145,000/mm3Serum Ca2+9.1 mg/dLSerum Urea Nitrogen24 mg/dLGlucose102 mg/dLCreatinine0.7 mg/dL A clean-catch midstream urine specimen shows: ✅ 2+ protein on dipstick ✅ WBCs with “glitter cells” too numerous to count ✅ WBC casts ✅ Numerous bacteria 📌 Voiding cystourethrography shows bilateral postmicturition urinary reflux. 📌 No evidence of hydronephrosis. Which of the following is the most likely cause of this patient’s disease process? A) Abnormal ureteral entry into the bladder B) Chronic diffuse bladder inflammation with increased mast cells C) Hematogenous bacterial seeding of renal cortex D) Periureteral soft-tissue mass E) Urethral stricture