Is presentation of bacteremia in the elderly the same as in younger patients?

Bloodstream infections in older patients

“…Leukocytosis is reported in 39-73% of patients aged 65 and older 17,[21][22][23]25,28 and in one study was more common than in younger patients and with higher median values. 23 Leukopenia is described in »10% of patients in most studies 17,20,22,25,28 and its prevalence is not significantly different than in younger patients.…”

“…Chills are reported in »35% of older patients 17,23,25,28 and significantly less prevalent compared to younger patients. 23 Altered mental status is reported in several studies to occur in as high as »50% of patients 65 y and older.…”

“…23 Altered mental status is reported in several studies to occur in as high as »50% of patients 65 y and older. 23,25,28,29 Other studies reported altered mental status in 12-17% in patients aged 65 y and older 17,20,22 and 21-26% in patients 85 y and older. 20,22 The variability, at least in part, can be explained by various definition of "altered mental status" (Table 2).…”

“…[17][18][19][20][21] In a recent large prospective study including 2605 patients aged 65 y and older with bacteremia, absence of fever was documented in 6.3%. 14 Moreover, in most studies no significant difference from younger patients is demonstrated in the prevalence of fever 17,19,20,22 or in median temperature on presentation. 23 Hypothermia is reported in 0.3-10%.…”

“…23 Hypothermia is reported in 0.3-10%. 17,20,22,24,25 Definition of fever and site of measurement influence the results. Darwosky et al found that in patients aged 70 y and older sublingual temperature readings detect about one-third of fevers and that rectal temperature measurement will detect fever in up to 86% of infected patients.…”