There are alternating linear areas of contrast opacification of the renal parenchyma at the nephrographic and excretory phases giving the appearance of "striated nephrogram". Differential diagnosis includes acute pyelonephritis, renal vein occlusion, and acute ureteric obstruction. CT urography can provide good discrimination between the causes aided by the clinical status and laboratory studies. On the non-contrast study, there are no stones or evidence of acute ureteric obstruction. Renal vessels are well opacified. The marked stranding and the evolving microabscesses are consistent with the laboratory results of urinary tract infection.