患者，女,45岁。尿频、尿急、尿痛2天，伴高热、寒战、腰痛半天。査体:T39，BP110/70mmHg，左肾区有叩击痛。尿常规:蛋白（+)，RBC2-5/HP,WBC40-50/HP。最可能的诊断是

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