INFECTION IN THE OLDER PATIENT

Abstract

In older people afflicted with one of several types of infectious diseases, the morbid process may exhibit patterns which differ considerably from those in the young or middle aged person. As practitioners of medicine, we are called upon to treat more and more older people. It behooves us, therefore, to understand the nature of these altered disease patterns and to utilize this knowledge in practice. It is appreciated generally that the body's defense mechanism against an infectious agent is inflammation. The pathogenesis of the inflammatory reaction is a complex of vasohumoral alterations, which produce a local response to combat the invading organism and systemic changes to support the combat. In older people, the dynamics of inflammation are obtunded, with diagnostic signs and symptoms so unlike the disease as seen in younger individuals that the diagnosis is difficult and may be made late. A number of examples of these altered morbid