ISSN:0304-324X    

DOI:10.1159/000212644

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:0304-324X    

DOI:10.1159/000212645

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Infectious diseases are major causes for morbidity and mortality in the elderly population. A variety of factors contribute to the elderly person’s increased susceptibility to infection. Diagnosis of infections in the old individual is often difficult, and antimicrobial strategies may have to be altered in this patient population. Newer and innovative strategies in management are needed in the field of aging and infection

ISSN:0304-324X    

DOI:10.1159/000212646

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Age-related immune dysfunction contributes to the vulnerability of old individuals to infection, e.g., animal model studies demonstrate the association between age-related decline in T cell-dependent immunologic responses and the decline in resistance against viral, bacterial, and parasitic infections. This review briefly describes age-related changes in the immune system at the systemic, tissue and cellular levels. At the systemic level, emphasis is on polymorphic effects of aging; at the tissue level, emphasis is on the vulnerability of primary tissues engaged in the generation of antigen-responsive cells and on the difference in the onset and rate of changes between different peripheral tissues of the system; and at the cellular level, emphasis is on the qualitative changes at the surface receptor, cytoplasmic and nuclear levels.

ISSN:0304-324X    

DOI:10.1159/000212647

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A prospective study of 340 patients admitted to an acute geriatric male ward for a 12-month period was carried out to determine the aetiology and incidence of lower respiratory tract infection (LRTI) acquired either prior or after admission to the hospital. Over the year, 120 patients (35%) were found to have LRTI; a specific aetiology was found in 44 (37%) patients. The pathogens most frequently isolated were Haemophilus influenzae (11 patients), Streptococcus pneumoniae (9 patients) and influenza A (4 patients). A further 8 (7 %) patients had antibody titres sufficiently raised to indicate a recent infection (influenza A 6, Chlamydia psittaci 2). A marked difference in the aetiology between community- and hospital-acquired infection was demonstrated. Cross-infection was not found, although patients with influenza A infection were admitted to the ward. Mortality showed a high correlation with current and ex-smokers.

ISSN:0304-324X    

DOI:10.1159/000212648

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Diagnosis of bacterial pneumonia in the elderly depends on an awareness of the various forms of presentation and identification of the etiologic agent(s). The reliability of sputum or nasopharyngeal aspirates can be assessed by the number of squamous epithelial cells and white blood cells per 100 × field (low-power). Transtracheal aspiration should be considered in select patients with life-threatening pneumonias. Community-acquired pneumonias are caused primarily by S. pneumoniae (40–60%), hospital-acquired pneumonias by gram-negative bacilli (45%) and institution-acquired pneumonias by mixed flora (35%) and S. pneumoniae (30%). Initial choice of antimicrobial agents is based on an interpretation of the Gram stain. Choice of empiric antimicrobial treatment depends on host characteristics and the setting in which the pneumonia occu

ISSN:0304-324X    

DOI:10.1159/000212649

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In the United States, an increasing proportion of all forms of reactivation tuberculosis occurs in patients over the age of 60 years. Atypical presentations and presence of chronic illness obscure the diagnosis of tuberculosis in the elderly. Prompt diagnosis requires a high index of suspicion and aggressive procedures for diagnostic microbiology. Short-course (9 months) chemotherapy with isoniazid and rifampin is the treatment of choice for elderly patients with uncomplicated pulmonary tuberculosis. Isoniazid chemoprophylaxis is recommended for selected elderly patients.

ISSN:0304-324X    

DOI:10.1159/000212650

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Infective endocarditis has become a disease affecting primarily elderly persons. The etiology of infective endocarditis in the elderly is predominantly streptococci and staphylococci. The clinical features of this infection in the aged may be atypical or nonspecific, which often leads to delays in diagnosis. Mortality is extremely high for elderly patients with infective endocarditis.

ISSN:0304-324X    

DOI:10.1159/000212651

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Intraabdominal infections in the elderly are major diagnostic and therapeutic problems encountered by clinicians. Biliary sepsis, diverticulitis, appendicitis, and intraabdominal abscess cause significant morbidity and mortality in the geriatric patient. The clinical manifestations, diagnostic approach, and treatment of these infections are formulated in this review.

ISSN:0304-324X    

DOI:10.1159/000212652

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Urinary tract infection (UTI) is an important infectious disease in the elderly. Its prevalence, etiology, clinical manifestations, and management differs significantly from UTI occurring in the general population. Catheter-related bacteriuria is a serious problem of elderly patients residing in nursing homes and extended care facilities.

ISSN:0304-324X    

DOI:10.1159/000212653

出版商:S. Karger AG    

年代:1984

数据来源: Karger