Abstract
Community-acquired pneumonia (CAP) in elderly has different clinical presentation and higher mortality than CAP in other age group. Clinical presentation may vary from mere presence of fever to altered sensorium. The incomplete clinical picture of CAP in the elderly may be associated with a delay in establishing the diagnosis and, consequently, in starting adequate antibiotic therapy. Delay in diagnosis and treatment may contribute to the higher observed death rate in the elderly population with CAP. Hence the following study was undertaken to study the clinical, radiological, and bacteriological profile of community-acquired pneumonia in elderly. A total of 50 patients were studied. Age group varied from 66 years to 88 years. Presentation varied from typical symptoms to altered sensorium. Smoking and COPD were most common predisposing conditions. Most common organisms responsible wereStreptococcus pneumonia,Klebsiella pneumonia,Pseudomonas,H. influenza, andStaphylococcus aureus. Etiological agents could not be identified in many cases because of difficulty in collecting sputum in elderly patients, lower yield of culture, and various atypical and difficult to isolate causative organisms. Hence there is need for an empirical therapy covering both typical and atypical organisms. Better understanding of these aspects may help a long way in managing elderly patients with pneumonia.
Highlights
Pneumonia “the captain of men of death,” “The friend of the aged, allowing them a merciful relief from those cold gradations of decay, that make the last state of all so distressing” as described by William osler, is one of the most common infectious disease encountered in the clinical practice [1].Pneumonia is the sixth leading cause of death in the United States [2]
Streptococcus pneumonia was the most common organism isolated, obtained in 8 (16%) patients, followed by Klebsiella pneumonia in 3 (6%) patients, Pseudomonas in 2 (4%), Hemophilus influenza in 2 (4%), Staphylococcus aureus in 1 (2%), and E. coli in 1 (2%) patients
Community-acquired pneumonia in elderly patients is a common and serious problem encountered in clinical practice
Summary
Pneumonia is the sixth leading cause of death in the United States [2]. About 600,000 persons with pneumonia are hospitalized each year, and there are 64 million days of restricted activity due to this illness [3]. In developed countries almost one half of total hospitalization for pneumonia occur in patients over 65 years, and pneumonia is a leading cause of death in this age group [4]. Managing pneumonia in an elderly patient requires an appreciation of many aspects of geriatric medicine, including the demographics of our aging population [5]. As stated by Sir William Osler, “In old age, pneumonia may be latent, coming on without chill, the cough and expectoration are slight, the physical signs ill defined and changeable, and the constitutional symptoms out of all proportion.”
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