INFECTIONS IN THE ELDERLY

Weakness, falls, incontinence or altered mental states may signal infe ction in the elderly, while fever may be absent. Bacteria are the most likely cause, and the most common sites are the respiratory system, t he 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 va ccination is recommended, and amantadine may protect against influenza A (not B) during outbreaks. A single pneumococcal vaccination is reco mmended for those with chronic cardiopulmonary disease or alcoholism o r for those who are immunosuppressed. All major hospitals and large nu rsing homes have committees which can give advice on infection control .