Fever in the Elderly

Abstract

Infections in the elderly, similar to other acute illnesses in this age group, may present in atypical, nonclassical fashions. Fever, the cardinal sign of infection, may be absent or blunted 20%-30% of the time. An absent or blunted fever response may in turn contribute to diagnostic delays in this population, which is already at risk for increased morbidity and mortality due to infection. On the other hand, the presence of a fever in the geriatric patient is more likely to be associated with a serious viral or bacterial infection than is fever in a younger patient. Finally, a diagnosis can be made in the majority of cases of fever of unknown origin (FUO) in the elderly. FUO is often associated with treatable conditions in this age group.

Fever of Unknown Origin in Taiwan

“…The relative proportion of tuberculosis, as compared with other studies and including two studies conducted in Japan [1,4,5,[10][11][12][13], was higher. In the latter studies, 2-11% of the patients with FUO had tuberculosis.…”

Adverse events and association with age, sex and immunological parameters of Q fever vaccination in patients at risk for chronic Q fever in the Netherlands 2011

“…This may be because elderly people tend to respond less with high temperature to vaccinations or infections [41]. The pre-vaccination IFN-␥ production, as measured in the whole-blood assay, showed a positive association with Vac-locAE, but the observed differences did not reach statistic significance.…”

Fever of unknown origin: What is remarkable in the elderly in a developing country?

“…This is in accordance with the undiagnosed case ratio of 7-38% obtained in different studies in developing and developed countries both. 10,[16][17][18][19][20][21] It is known that patients with unexplained FUO generally have a good prognosis, 22 however, there are not much data specifically on the elderly. Unfortunately, we did not have a long-term follow-up of these geriatric patients with unexplained FUO.…”