title: Presentation of infection in older patients--a prospective study.
abstract: BACKGROUND
  Traditional wisdom suggests that infections in older patients have atypical presentation, including blunted febrile response. Data are scarce.
  
  
  METHODS
  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).
  
  
  METHODS
  Single tertiary medical center.
  
  
  METHODS
  Patients admitted with suspected bacterial infection during 2002-2004 and 2010-2011.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Unit of Infectious Diseases, Rabin Medical Center, Beilinson Hospital , Petah-Tikva , Israel.
authors: Dafna
authors: D
authors: Yahav
authors: Agata
authors: A
authors: Schlesinger
authors: Vered
authors: V
authors: Daitch
authors: Yulia
authors: Y
authors: Akayzen
authors: Laura
authors: L
authors: Farbman
authors: Yasmin
authors: Y
authors: Abu-Ghanem
authors: Mical
authors: M
authors: Paul
authors: Leonard
authors: L
authors: Leibovici
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000382:microbiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
keywords: Elderly; geriatrics; infection presentation