Atypical presentation of geriatric infections

Infection is a common problem in elderly patients, the most common infections being those in the urinary tract and the respiratory tract. In geriatric practice, infection is most frequently seen in combination with many other problems. The geriatric presentation is described in which patients may present with an increased dependency upon care providers due to the development of fresh problems like falls, immobility, confusion, incontinence of urine, and fecal impaction with incontinence. It is important to recognize this presentation and not to miss the diagnosis. It is well recognized that pneumonia is the most frequently missed diagnosis in the elderly. An increase in dependency should not be ignored and attributed to old age. The presence of pathophysiological changes and organ involvement, together with fever, raised white count, or elevated ESR, are strongly supportive of a diagnosis of infection. Once identified, the infection can usually be appropriately treated, resulting in significant improvement in multiple geriatric problems which these patients suffer from.