This is
why I love the city. At any time of day,
there is a place where everyone is awake and waiting to help you, get you some
place or give you food. Cabs were
plentiful at 3am, cheery doctors and nurses were waiting for me, and some
people-watching helped pass the time.
Please don’t think I was in a good
mood (quite
the opposite), but I appreciated the beacon of civilization in the
middle of a miserable evening. I didn’t
feel so alone.
A quick
urine test sealed my fate – pyelonephritis, also known as a kidney
infection. Great. May I have some antibiotics, please, sir?
How does this happen? Urinary tract infections (UTIs)
happen when bacteria get in the urethra/bladder. They find it very cozy there and begin to
multiply. Early symptoms include bladder
pain, frequent need to pee, and pain during urination. If left untreated, the bacteria can spread up
to your kidneys. The symptoms then
progress to back pain, fever, shaking chills and vomiting. Women are more likely to get UTIs than men
due to shorter urethras and proximity to a haven of E. coli.
How does the test
work? I had wanted a urine analysis on Thursday afternoon but was unable to
get one (because
of my own inability to procure a primary care doctor when switching insurance. Seriously, this whole debacle was a series of
failures on my part). What would
a urine analysis have shown?
Human
urine contains nitrate, shown in Figure 51.1. Some bacteria are able to uptake nitrate and
turn it into nitrite (Figure 51.1). Presence of nitrite in your urine suggests
bacteria are present!
I got my urine analysis in the emergency room. After telling my story to the doctor, she asked the nurse if my analysis showed blood because my symptoms were more in tune with kidney stones than an infection.
"No," he happily replied. "No blood, but she had nitrites!"
How do the
antibiotics work? In order to clear the infection, the bacteria must be killed
so antibiotics are necessary. The word
antibiotic is quite simple: “anti” means against in Greek, while “bios” means “life.” Many different kinds of antibiotics exist,
but they all do the same general thing: disrupt bacterial cells without
disrupting human cells. How does one achieve
this?
In
broad strokes, bacteria do the same functions as human cells: replicate their
DNA, transcribe DNA into RNA, translate RNA into protein (Central Dogmapost), but the proteins they use to do it are a bit different than human
proteins. For example, a protein known
as DNA Polymerase is responsible for replicating DNA in cells. Human DNA polymerase looks very different
than bacterial DNA polymerase. If you
can identify a drug that will – say – bind to bacterial DNA polymerase and make
it unable to function, then the bacteria will die. Since human DNA polymerase looks different,
that same molecule can’t inactive human DNA polymerase. Win. You
kill bacteria cells without killing human cells!
Antibiotics
target different things. Some keep
bacteria from making their cell walls, some inhibit different enzymes necessary
for bacterial life. My drug of choice is
levofloxacin, which specifically blocks bacterial topoisomerase IV and DNA
gyrase. Both of these are involved in unwinding
DNA for replication. If the bacteria can’t
unwind their DNA, they can’t replicate it or continue to grow.
After
three doses of antibiotics, I feel almost human. I have three more to go. Bouncing back from this hasn’t been quite as
fast as I’d hoped (today is the first day I can sit at my computer and focus on
work), but the shivering chills have stopped and I’m slowly regaining my
appetite. I have weird cravings when I’m
sick – tonight, all I want for dinner is fried chicken.
Much more
info is available on UTIs, kidney infections, and antibiotics. Read more if you are interested! Also, if you get any of those symptoms, go to
a freaking doctor! Don’t be stupid like
me.
My apologies for being a little
MIA in the past week. Obviously, this is
why. I’m working to update all my blogs
now and catch up on work that I’ve missed over the past week. I have all the Sickle Cell posts outlined so
they should be up soon!
REFERENCES
UTI Info from the Mayo Clinic: http://www.mayoclinic.com/health/urinary-tract-infection/DS00286
Some medical info on urine cultures, common UTI bacteria: http://www.medindia.net/education/familymedicine/utinfection-urineculture.htm
Generalized antibiotic information: http://www.medicalnewstoday.com/articles/10278.php
Levofloxacin information: http://bacteria.emedtv.com/levofloxacin/levofloxacin.html
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