Infections in the elderly.

Abstract

Weakness, falls, incontinence or altered mental states may signal infection in the elderly, while fever may be absent. Bacteria are the most likely cause, and the most common sites are the respiratory system, the urinary tract and the soft tissues. Joint infections and meningitis must be remembered, as must bacterial endocarditis. Herpes zoster may be ameliorated by early treatment with acyclovir. Annual influenza vaccination is recommended, and amantadine may protect against influenza A (not B) during outbreaks. A single pneumococcal vaccination is recommended for those with chronic cardiopulmonary disease or alcoholism or for those who are immunosuppressed. All major hospitals and large nursing homes have committees which can give advice on infection control.