Sepsis induced by purulent spondylodiscitis and pyelonephritis in an 80-years-old man
Authors:
P. Makovičková 1; P. Weber 1; F. Sokol 2; J. Mrázová 3
Authors‘ workplace:
Lékařská fakulta Masarykovy univerzity a FN, Brno
Klinika interní, geriatrie a praktického lékařství
Přednosta: prof. MUDr. Hana Matějovská Kubešová, CSc.
1; Ústav patologie MU a FN, Brno
Přednosta: MUDr. Leoš Křen, Ph. D.
2; Radiologická klinika MU a FN, Brno
Přednosta: prof. MUDr. Vlastimil Válek, CSc., MBA
3
Published in:
Prakt. Lék. 2015; 95(5): 225-227
Category:
Case Report
Overview
The article describes a case of sepsis with purulent spondylodiscitis and pyelonephritis in an 80-years-old patient, which ends with death of the patient. The patient comes to the hospital with completely non-specific and less pronounced symptoms than in a usual clinical type of the disease. The article deals with the dif-ferences in the response of immune system of geriatric patients. It also tries to explain the possibility of misinterpretation of the symptoms of a systemic infection on the basis of the altered cellular responses. These systemic infections could be fatal if unnoticed, especially for the old man. The aim of this article is to focus on some of the difficulties of diagnosis and therapy of sepsis and spondylodiscitis in the geriatric patients and to point out the atypical nature of the clinical picture of severe life-threating illness in elderly age.
Keywords:
sepsis in elderly – pyelonephritis – spondylodiscitis
Sources
1. Novák I, Cvachovec K, Černý V. Sepse v intenzivní péči: vybraná doporučení v diagnostice a terapii. Praha: Maxdorf 2002.
2. Kubešová H. Úskalí infekčních komplikací ve stáří. Čes Ger Rev 2008; 6(1): 6–13.
3. Krejsek J, Kopecký O. Klinická imunologie. Hradec Králové: Nucleus 2004.
4. Heppner HJ, Cornel S, Peter W, et al. Infections in the elderly. Crit Care Clin 2013; 29(3): 757–774.
5. Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother 2010; 65(Suppl 3): iii11–iii24.
6. Šimončičová, A. Spondylodiscitida – „ortopedické“ onemocnění často diagnostikované internisty. Interní Med 2012; 14(12): 481–483.
7. Beharka R, Pacík D. Infekce močových cest v gerontologii. Čes Ger Rev 2004; 3: 19–23.
8. Hájková B. Infekce močových cest u seniorů. Čes Ger Rev 2008; 6(1): 14–18.
9. Rajapakse S, Rajapakse A. Age bias in clinical trials in sepsis: how relevant are guidelines to older people? J Crit Care 2009; 24(4): 609–613.
10. Zuliani G, Galvani M, Sioulis F, et al. Discharge diagnosis and comorbidity profile in hospitalized older patients with dementia: Hospitalization in older demented subjects. Int J Geriatr Psychiatry 2012; 27(3): 313–320.
11. Bail K, Berry H, Grealish L, et al. Potentially preventable complications of urinary tract infections, pressure areas, pneumonia, and delirium in hospitalised dementia patients: retrospective cohort study. BMJ Open 2013; 3(6): e002770.
12. Kalvach Z. Geriatrické syndromy a geriatrický pacient. Praha: Grada Publishing 2008.
13. Kalvach Z. Geriatrie a gerontologie. Praha: Grada Publishing 2004.
14. Simon C, Stille W, Hejzlar M. Antibiotika v současné lékařské praxi. Praha: Grada Publishing 1998.
Labels
General practitioner for children and adolescents General practitioner for adultsArticle was published in
General Practitioner
2015 Issue 5
Most read in this issue
- White oral lesions – differential diagnosis
- Sexology profile of patients after spinal cord injury
- Sleep problems of the elderly depending on the environment
- The use of assessment tools for assessment fear of pain in children