ABSTRACT
Concomitant with the process of aging of the United States population, health care professionals and emergency departments can expect to encounter steady increases in the numbers of acutely ill older persons. Among other geriatric emergencies, serious infections result in significant morbidity and mortality in elderly individuals (1). Infectious diseases account for one of the five leading causes of death and one of the top 10 indications for hospitalization in persons aged 65 years or older (2). Pneumonia and influenza represent the fifth leading cause of death in the elderly (3) and meet the most frequent admission criteria for hospitalization in the frail elderly (4). Chronic medical conditions and functional disability are associated with a heightened risk for serious infection in the elderly. Treatment is often delayed because of atypical presentations and the scarcity of classic clinical clues that are frequently masked and confounded by co-existing and comorbid conditions, as well as age-related changes (4,5). Associated factors, such as malnutrition, alcoholism, immobility, institutionalization, and urinary incontinence, superimposed on underlying illness (e.g., diabetes mellitus, cerebrovascular accidents (CVAs), malignancies) and altered immune function with senescence further contribute to this enhanced risk for severe infections with aging (6).
