Urosepsis: Pathogenesis and Clinical Manifestation

Running Head: UROSEPSIS 1
UROSEPSIS
Name
Date
Institution

UROSEPSIS 2
Urinary Tract infection
Pathogenesis in relation to Clinical Manifestation
Sepsis refer to a complex inflammatory response of a host to an infection. Urosepsis is
therefore a severe infection of the urinary tract accompanied by systemic inflammatory response
syndrome (Kalra and Raizada 2009). The CDC reports that urinary tract infections are the most
common bacterial infections. One of the risk factors for UTIs is age. For instance, Mr Kirkman’s
age, for instance, puts him at risk of developing urinary tract infections. A urinary tract infection
starts when the bacterial colonization of the bladder (Porat and Kesler, 2018). The infection
sometimes ascends through the ureters to the kidneys. The most common precursor of urosepsis
us complicate UTI infection, which can be defined as an infection in a patient whose structural
and functional system have an abnormality (Kalra and Raizada 2009).
After infection with the pathogen, the body’s response determines development of sepsis
and its severity. The pathogen’s proteins then interact with the proteins of the body triggering an
immune response. The immune response leads to an increase in neutrophils which subsequently
causes production of bactericidal substances and formation of edema from increased
permeability of endothelial cells (Craft et al, 2015). Afterwards, the anti-inflammatory response
causes suppression of the immune system. Lifestyle behaviors like smoking and heavy drinking,
as in the case of Mr. Kirkman, suppress the immune system, making the body more susceptible
to infection. In elder patients, the typical UTI manifestations may not be present or may be vague
and replaced by findings like worsening mental state (Brusch, 2018)
Some causes of UTIs include presence of urinary catheters and prosthetics, and other
infections like epididymitis, pyelonephritis and cystitis. UTIs are more common in women but it

UROSEPSIS 3
is speculated that they are more chronic in men (Dreger et al, 2015). Diagnosis of UTIs includes
laboratory analysis of full blood count and urinalysis coupled with the signs and symptoms.
Laboratory results of Mr. Kirkman show that his hemoglobin, red blood cells, platelets and
packed cell volume and platelets were within normal ranges. However, his white blood cells
were elevated which can be attributed to the underlying inflammatory process (Craft et al, 2015).
Systemic inflammation is usually evidenced by high body temperatures, tachycardia, respiratory
alkalosis with PaCO2 of less than 32mmHg and elevated white blood cells (Kalra and Raizada,
2009).
Presentation of urinary tract infections is dependent on several factors and how they
affect the immunity. In Mr. Kirkman’s case, his drinking and smoking might have exacerbated
his illness as his history reveals a previous UTI infection. Levels of creatinine and urea were
elevated indicating abnormal functioning of the kidneys. In addition, his electrolytes levels were
also elevated. Sodium was 148mmol/l, Mg2+ levels were 0.82mmol/, Potassium was 5.2mmol/l
and CL - was 111mmol/l. these tests indicate the functionality of the urinary system. Elevated
electrolytes, creatinine and urea are a result of abnormal ultrafiltration which causes elevated
urine excretion as a result of bacteria in the urinary tract (Wagenlehner et al, 2013).
Bacteria in the urinary tract cause activation of the complement and innate immune
systems that lead to a pro-inflammatory reaction that includes both neutrophils and macrophages.
Bactericidal substances are then produced as a result of increased neutrophils. Subsequent
stimulation of B and T lymphocytes occurs producing more cellular immune reaction which is
amplified by secondary mediators (Craft et al, 2015). This process leads to degradation of
muscular proteins and antibody synthesis. The endothelial cells then produce the platelet