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Acute pyelonephritis in the elderly

R Gleckman, N Blagg, D Hibert

    Southern Medical Journal
    |May 1, 1982
    PubMed
    Summary
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    Acute bacterial pyelonephritis in elderly patients, often causing gram-negative bacteremia, has a high survival rate with appropriate antibiotic therapy. Elderly women show increased risks of bacteremia and septic shock compared to younger women.

    Area of Science:

    • Infectious Diseases
    • Geriatrics
    • Internal Medicine

    Background:

    • Bacterial pyelonephritis is a common cause of gram-negative bacteremia in hospitalized elderly patients.
    • Community-acquired urinary tract infections (UTIs) pose significant health risks for older adults.

    Purpose of the Study:

    • To prospectively investigate the clinical, laboratory, radiologic, and therapeutic features of acute, symptomatic, bacterial pyelonephritis in elderly patients.
    • To identify distinguishing characteristics of pyelonephritis in elderly women compared to younger populations.
    • To establish guidelines for diagnosis and treatment of community-acquired pyelonephritis in the elderly.

    Main Methods:

    • Prospective study of 35 consecutive elderly, noncatheterized patients hospitalized with acute, symptomatic, bacterial pyelonephritis.

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  • Analysis of clinical presentation, laboratory results, radiologic findings, and therapeutic interventions.
  • Comparison of pyelonephritis features between elderly women and younger women.

    • Main Results:

    • Pyelonephritis was the most common cause of gram-negative bacteremia in this elderly cohort.
    • A 97% survival rate was observed, attributed to appropriate antibiotic therapy and absence of severe comorbidities.
    • Elderly women exhibited a higher incidence of bacteremia and septic shock compared to younger women.

    Conclusions:

    • Acute bacterial pyelonephritis in the elderly requires prompt diagnosis and effective antibiotic management.
    • Increased vigilance for bacteremia and septic shock is warranted in elderly women with pyelonephritis.
    • Guidelines for diagnostic evaluation and antibiotic therapy are crucial for managing community-acquired pyelonephritis in older adults.