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Abstract
Background. Traditional wisdom suggests that infections in older patients have atypical presentation, including blunted febrile response. Data are scarce.
Design. We analyzed data from a prospectively collected database on presentation of infection in 4,308 patients, and compared the presentation of older patients (≥ 75 years) versus adults (< 75 years).
Settings. Single tertiary medical center.
Participants. Patients admitted with suspected bacterial infection during 2002–2004 and 2010–2011.
Measurements. We evaluated clinical presentation on day of admission, including vital signs and laboratory parameters.
Results. No difference in fever values as a presenting sign of infection was found between older patients and adults (median fever 38.3°C, interquartile range [IQR] 37.4–39.0°C; and 38.4°C, IQR 37.3–39.0°C, respectively, P = 0.08). Median leukocyte count was significantly higher in older patients (median 11.60, IQR 8.30–15.72 in older patients; 10.84, 7.50–15.00 in adults, P < 0.001). Presentation with septic shock, acute renal failure, and reduced consciousness was significantly more common in older patients. These findings were also consistent in the subgroups of bacteremic patients and patients with microbiologically documented infection.
Conclusion. Elevated fever and leukocytosis were found to be at least equally common in older patients compared to younger adults as part of the presentation of infection.
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Acknowledgements
L.L., M.P. and D.Y. planned the study; Y.A., Y.A.-G., V.D., A.S., and L.F. collected the data; L.L., M.P., D.Y., and A.S. analyzed the data; D.Y. wrote the manuscript and all other authors commented on the manuscript.
M. Paul and L. Leibovici are active members of the European Society of Clinical Microbiology and Infectious Diseases–Study Group for Infections in the Elderly (ESGIE) and would like to thank the ESGIE members for their stimulating support.
Declaration of interest: The authors report no conflicts of interest.
Funding: None.
Supplementary material available online
Supplementary Table I to be found online at http://informahealthcare.com/doi/abs/10.3109/07853890.2015.1019915