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Pathology - Urinary Tract Infection
Pyelonephritis is a result of ascending infection from the lower urinary tract. Bacteria enter the urinary tract at the urethra and rise to the bladder, ureters, and kidneys. There are some mechanisms to restrict bacterial development, including acidic urine pH. However, females are more prone to developing UTIs due to the shorter urethral length and proximity of the urethral meatus to the vaginal introitus and anus.
Once the infection reaches the kidneys, it can spread hematogenously and produce signs of sepsis and eventually septic shock if left untreated. Therefore, patients should be hospitalized and treated with empiric intravenous antibiotics until the microorganism sensitivities are identified from the urine culture. The presence of nitrites in the urine suggests the presence of nitrate-reducing bacteria, whereas the presence of leukocyte esterase shows white blood cells in the urine. It is crucial to highlight that patients can have a UTI without the presence of nitrites in the urine if the infection is secondary to a bacterium that does not decrease nitrates.
Pyelonephritis is a result of ascending infection from the lower urinary tract. Bacteria enter the urinary tract at the urethra and rise to the bladder, ureters, and kidneys. There are some mechanisms to restrict bacterial development, including acidic urine pH. However, females are more prone to developing UTIs due to the shorter urethral length and proximity of the urethral meatus to the vaginal introitus and anus.
Once the infection reaches the kidneys, it can spread hematogenously and produce signs of sepsis and eventually septic shock if left untreated. Therefore, patients should be hospitalized and treated with empiric intravenous antibiotics until the microorganism sensitivities are identified from the urine culture. The presence of nitrites in the urine suggests the presence of nitrate-reducing bacteria, whereas the presence of leukocyte esterase shows white blood cells in the urine. It is crucial to highlight that patients can have a UTI without the presence of nitrites in the urine if the infection is secondary to a bacterium that does not decrease nitrates.
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