Document Detail


Is presentation of bacteremia in the elderly the same as in younger patients?
MedLine Citation:
PMID:  8579089     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the presentation of bacteremia in young and elderly patients. PATIENTS AND METHODS: Seventy-one elderly (mean age 80.4 years) and 34 younger inpatients (mean age 45.7 years) with bacteremia were prospectively studied. These were compared with a control group of 187 geriatric patients (mean age 81.3 years) with clinical signs of bacteremia but in whom blood cultures were negative. Bacteremia was defined as one or more positive blood cultures showing a pathogenic bacteria in patients with clinical signs of bacteremia. In all 105 patients with bacteremia, 16 common clinical or biological signs of the disease were immediately investigated after blood culture. Patients were classified into three groups: elder patients and young patients with bacteremia and elderly patients without bacteremia. RESULTS: Only three clinical findings of the 16 studied were found in at least 70% of the bacteremic elderly patients: fever, increased erythrocyte sedimentation rate, and a clinical indication of the source of infection. These three signs were found statistically more often in bacteremic elderly compared with nonbacteremic elderly patients (P < 0.01). Seven other signs (hypothermia, altered mental state, leukopenia, and lymphopenia) had a specificity above 80%. On a logistic regression analysis, four variables were significantly and independently associated with bacteremia in the elderly: rapid onset of infection (defined as a period < or = 48 hours between the earliest manifestation of bacteremia and the time of blood blood sample), fever, altered general state, and clinical indication of the source of infection. Younger infected patients had more chills, sweating, alter general state, altered mental state or lymphopenia than did the bacteremic elderly patients. Bacteremic elderly patients had statistically few symptoms than the young infected patients (P < 0.001). CONCLUSIONS: In elderly patients with early stage bacteremia, most of the signs or symptoms that are considered typical in the literature appear irregularly. None appeared pathognomonic. Elderly patients with bacteremia had fewer signs or symptoms than younger infected patients.
Authors:
P Chassagne; M B Perol; J Doucet; C Trivalle; J F Ménard; N D Manchon; Y Moynot; G Humbert; J Bourreille; E Bercoff
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of medicine     Volume:  100     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-03-14     Completed Date:  1996-03-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  65-70     Citation Subset:  AIM; IM    
Affiliation:
Département de Gérontologie, CHU de Rouen, Hopital de Boisguillaume, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aging*
Bacteremia / blood,  diagnosis*,  microbiology,  physiopathology
Bacteria / isolation & purification
Blood Sedimentation
Case-Control Studies
Female
Fever / physiopathology
Humans
Hypothermia / physiopathology
Leukopenia / physiopathology
Logistic Models
Lymphopenia / physiopathology
Male
Mental Disorders / physiopathology
Middle Aged
Prospective Studies
Sensitivity and Specificity
Splenomegaly / physiopathology
Sweating / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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