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Bacteremic pneumococcal pneumonia in the elderly.

T F Murphy, B C Fine

    The American Journal of the Medical Sciences
    |October 1, 1984
    PubMed
    Summary
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    Pneumococcal pneumonia in the elderly often presents subtly, with fever, confusion, and dehydration being common. Early recognition of these signs is crucial for timely treatment and reducing high mortality rates.

    Area of Science:

    • Medicine
    • Infectious Diseases
    • Geriatrics

    Background:

    • Pneumococcal pneumonia is a significant health concern in the elderly population.
    • Bacteremic pneumococcal pneumonia presents unique diagnostic challenges in older adults.

    Purpose of the Study:

    • To review the clinical and laboratory features of bacteremic pneumococcal pneumonia in elderly patients.
    • To identify common presentations and associated pathogens.
    • To assess the prevalence of vaccine-serotype pneumococcal infections.

    Main Methods:

    • Retrospective review of 29 elderly patients with bacteremic pneumococcal pneumonia over five years.
    • Analysis of clinical manifestations, laboratory findings, and sputum/blood cultures.
    • Serotyping of blood isolates to determine capsular types.

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    Main Results:

    • 50% of patients lacked typical pneumonia symptoms; common presentations included fever, altered mental status, and dehydration.
    • 60% had other pulmonary pathogens identified alongside pneumococcus.
    • Reversible liver function abnormalities were frequent.
    • 69% of infections were caused by vaccine-included serotypes.

    Conclusions:

    • Subtle presentations of pneumococcal pneumonia in the elderly necessitate heightened clinical awareness for earlier diagnosis and treatment.
    • The presence of other pathogens and reversible liver abnormalities are notable findings.
    • Continued surveillance of pneumococcal serotypes is vital to monitor vaccine impact and emergence of non-vaccine types.
    • The high mortality rate underscores the need for effective pneumococcal vaccines in this demographic.