Skin and soft tissue infections in the elderly

Area of Science:

• Geriatric Medicine
• Infectious Diseases
• Dermatology

Background:

• Elderly patients face increased risk of skin and soft tissue infections (SSTIs) due to comorbidities and skin changes.
• Atypical clinical presentations and absence of typical severity signs (fever, elevated C-reactive protein) complicate diagnosis in older adults.
• The COVID-19 pandemic emphasizes the need for effective outpatient management and early hospital discharge.

Approach:

• Reviewing the unique challenges in diagnosing and managing SSTIs in the elderly population.
• Highlighting the importance of accurate diagnosis to prevent antibiotic overtreatment.
• Discussing risk factors for methicillin-resistant Staphylococcus aureus (MRSA) and the need for targeted screening and therapy.

Key Points:

• Elderly patients present unique challenges for SSTI diagnosis and management.
• Atypical symptoms and comorbidities can mask infection severity.
• Screening for MRSA and early, targeted antibiotic therapy are vital for high-risk individuals.
• Long-acting antibiotics may be suitable, but require careful clinical follow-up.

Conclusions:

• Optimal management of SSTIs in the elderly focuses on accurate diagnosis, preventing overtreatment, and considering resistant pathogens like MRSA.
• Early discharge and outpatient management strategies are essential, particularly in the current healthcare climate.
• Further research is needed to understand superinfections in pressure ulcers and lower limb erythema in this demographic.