title: Clinical conundrums in management of sepsis in the elderly.
abstract: In 2012, surviving sepsis campaign came out with updated international guidelines for management of severe sepsis and septic shock. Paradoxically, there are no specific guidelines for management of sepsis in the elderly, although the elderly are more predisposed to sepsis, and morbidity and mortality related to sepsis. Sepsis in the elderly is, more often than not, complicated by clinical conundrums such as congestive heart failure (CHF), atrial fibrillation (AF), chronic kidney disease (CKD), acute kidney injury (AKI), delirium, dementia, ambulatory dysfunction, polypharmacy, malglycemia, nutritional deficiencies, and antibiotic resistance. Also, with recurrent admissions to the hospital and widespread use of antibiotics, the elderly are more susceptible to Clostridium difficile colitis.
authors.affiliation: Department of Internal Medicine, The Common Wealth Medical College, Scranton, PA 18510, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Sehgal
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Gian Sagar Medical College, Banur, Patiala, Punjab, India.
authors.forename: Sukhminder Jit Singh
authors.initials: SJ
authors.lastname: Bajwa
authors.affiliation: Chairman Emergency Medicine, Regional hospital of Scranton, PA, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Consalvo
authors.affiliation: Department of Internal Medicine, WCGME, SCRANTON, PA, USA.
authors.forename: Anurag
authors.initials: A
authors.lastname: Bajaj
keywords: antibiotic resistance; atrial fibrillation; chronic kidney disease; congestive heart failure; elderly; malglycemia; sepsis