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The atypical presentation of infection in old age
Abstract:
A study was designed to determine the incidence of atypical or geriatric presentation of infection in a long-term-care-hospital population of aged veterans. During the 6-month period of surveillance there were 65 instances of functional decline among the 143 veterans, with 50 episodes of infection. Although the symptoms and signs of infection were attenuated in many patients, a diagnosis was reached by careful examination and investigation. The majority of patients had a temperature of at least 38 degrees C in the presence of infection and it is concluded that the afebrile response to infection is rare in this population. During the course of this study the death rate in this institution dropped to about half of what was anticipated, and returned to previous levels following completion of the study. Infection can be recognized at a very early stage despite an atypical geriatric presentation and early treatment reduces morbidity and mortality.
Insights
Infections in aged veterans often present atypically. Early recognition and treatment of these geriatric infections significantly reduce mortality and morbidity.
Area of Science:
- Geriatric Medicine
- Infectious Diseases
- Internal Medicine
Background:
- Atypical presentations of infections are common in elderly patients.
- Long-term care hospital settings house vulnerable aged veteran populations.
- Understanding infection patterns in this demographic is crucial for effective healthcare.
Purpose of the Study:
- To determine the incidence of atypical or geriatric presentations of infection.
- To evaluate the diagnostic challenges and outcomes in aged veterans with infections.
- To assess the impact of early infection recognition on morbidity and mortality.
Main Methods:
- A 6-month surveillance study was conducted in a long-term-care hospital.
- Data collected on functional decline, infection episodes, and patient symptoms.
- Careful clinical examination and investigation were employed for diagnosis.
Main Results:
- 65 instances of functional decline and 50 episodes of infection were recorded among 143 veterans.
- Infection symptoms were often attenuated, but diagnosis was achievable.
- The majority of infected patients presented with a temperature of at least 38°C, indicating afebrile response is rare.
Conclusions:
- Infection in aged veterans can be recognized early despite atypical geriatric presentations.
- Prompt diagnosis and treatment of infections in this population reduce morbidity and mortality.
- The study observed a significant, albeit temporary, decrease in the institution's death rate during the surveillance period.