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Atypical presentation of bacteremia in older patients is a risk factor for death

American Journal of Medicine Sep 06, 2019

Hyernard C, Breining A, Duc S, et al. - Because the absence of fever in bacteremia in older patients is known to delay diagnosis, researchers determined whether atypical presentation—the absence of a temperature ≥ 38.3°C or < 36°C, chills, or hypotension—in this population may be correlated with mortality due to bacteremia, as well as possible factors related to this atypical presentation. They conducted an observational prospective study in two French university hospitals in 2016-2017, involving patients aged ≥ 75 years with bacteremia. Of the 151 patients registered (mean age 85.4 ± 5.8 years), the atypical prevalence of presentation was 21.2%. In the short and long terms, older patients with bacteremia demonstrated poor vital and functional prognoses. Mortality was correlated with the lack of typical signs of infection. For older patients, particularly with diabetes and acute unexplained clinical manifestations, the researchers suggested that blood culture should be considered.

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