infections in the elderly Flashcards
what is the MC COD in pt >65
infection
main cellular feature w/ age
dec T cell response and dec T cell-macrophage response
what is absent in about 50% of elderly infections
fever
why do elderly pts present w/o fever
low T cells causes low IL2 which means inflammation is not activated, which causes fever
What phase of liver metabolism is affected by age
Phase I
what is needed to institute long term abx therapy in elderly: UTI w/ and w/o catheter
Fever And (no catheter) / Or (catheter) 1 UTI symptom
what is needed to institute long term abx therapy in elderly w/ skin/soft tissue infection
fever OR 1 skin inflammation
what is needed to institute long term abx therapy in elderly w/ respiratory infection ( fever, afebrile and COPD, afebrile w/o COPD)
fever: >102 fever AND RR>25/cough
afebrile and COPD: tx w/ new or worsened cough
afebrile w/o COPD: tx w/ new or worsened cough AND > 25RR
what is needed to institute long term abx therapy in elderly w/ fever w/ out source of infection
new onset delirium and rigors
what is the strongest predictor of mortality in elderly
comorbidity
MC community acquired Pneumonia in elderly
pneumococcus
MC long-term facility acquired Pneumonia in elderly
Polymicrobe
MC Hospital acquired Pneumonia in elderly
G - rod
how do you prevent pneumonia in elderly
immunization, dec smoking, dec comorbidity, infection control in nursing home
MC cause of UTI in elderly
G - rod
if asymptomatic bacteruria what do you treat w/
you do not treat
what is the MC cause of TB in elderly
reactivation
what causes infective endocarditis in elderly
BEhAVe: bovis, enterococcus, aureus/albicans, viridans
MCC of septic arthritis
S. aureus
MCC of osteomyelitis
S. aureus
MCC of bacterial meningitis
pneumococcus
What is the most treatable infectious cause of dementia
HIV/AIDS
what increases your risk of shingles
age
temperature of >101 for 3 wks
fever of unknown origin
pt w/ stroke/dimentia + CSF VDRL test
neurosyphilis
what are the causes of Bells palsy
HSV, VZV, lyme dz
