[Acute pneumopathies in the aged].
Acute infectious pulmonary diseases have a particular importance in elderly subjects because of their frequency and severity. This particular sensitivity to respiratory infections is linked to the global reduction in defense immune mechanisms: reduction in T-lymphocyte response in the presence of mutagens, reduction of the late hypersensitivity reactivity, alteration of B- and T-lymphocytes cooperation, reduction in bacterial opsonization. The presence of associated chronic diseases like chronic obstructive airway diseases, cardiovascular diseases, diabetes, renal failure or cancers is, for a large part, responsible for these infections. The diagnosis is often difficult because of the paucity and the lack in specificity of clinical signs. Radiological and, eventually, bacteriologic investigations are most often necessary to limit the prescription of multiple antibiotic treatments that are responsible of serious side effects direct and/or related to possible drug interactions. These risks are indeed increased because of the modification in metabolism and the pharmacokinetics of antibiotics in elderly subjects. Criteria for hospitalizing elderly subjects with an acute pulmonary infection are not different from those which apply in younger patients, but they imply more awareness. It is also important to take into account socioeconomic conditions and the individual functional capacities in the initial assessment of the severity of the condition. In conclusion, the multiple aspects and the potential severity of pulmonary infections in older subjects require a particular awareness, a more precise diagnosis and the initiation of antibiotics based on a probabilistic judgment, most often during an hospitalization.
Yernault
J C
JC
Service de Pneumologie, Hôpital Erasme, Bruxelles.
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D008171:Lung Diseases / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D009504:Neutrophils / Q000276:immunology; D010587:Phagocytosis; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000276:immunology; D012737:Sex Factors
Les pneumopathies aiguës du sujet âgé.