This question involves the requirement for C3 and the effect of the complement system on infections.
Question A: He should be told about the complement system and how it helps to protect against bacterial infections. After explaining the importance of the system it will be easier for him to understand that the lack of C3 essentially negates the function of the complement system. It would also help to explain to him that this is a genetic defect and not his fault.
Question B: This is a difficult question because broad-spectrum antibiotic therapy may be the best for alleviation of the infection; it will also increase the possibility of antibiotic resistance. Therefore a more conservative selection of potential antibiotics would be better for this patient.
Question C: You should be truthful about these infections continuing. This is because of the lack of C3 and there is no way to reverse this genetic defect. It would be helpful to reiterate to him that he must be more careful about exposure to infection which requires paying attention to personal hygiene and exposure to potential infectious situations.
Explain to him that the body’s defense against infection involve both the innate and adaptive immune responses. Part of the innate response, which is the first line of defense against infection, is the inflammatory response. This response is very powerful and is one of the major reasons why we recover from infection. Unfortunately, this protective response can also cause collateral damage of the tissues where it is working to stop the infection. It is likely that during this excessive inflammatory response, some of the kidney tissue was damaged and caused blood to infiltrate the urine.