Title: Viral lower respiratory tract infection in the elderly: a prospective in-hospital study
Authors: Flamaing, Johan ×
Engelmann, I
Joosten, Etienne
Van Ranst, Marc
Verhaegen, Jan
Peetermans, Willy #
Issue Date: Dec-2003
Publisher: Springer-Verlag
Series Title: European Journal of Clinical Microbiology & Infectious Diseases vol:22 issue:12 pages:720-725
Abstract: The objective of this prospective study was to evaluate the clinical and laboratory parameters distinguishing viral from nonviral lower respiratory tract infection in elderly patients and to determine the yield of virological diagnostics in elderly patients with lower respiratory tract infection. The study was conducted in a 184-bed geriatric department in a university hospital during 4 winter months. All consecutive elderly persons admitted with a lower respiratory tract infection were included in the study. Clinical and laboratory parameters, a nasopharyngeal swab, and serological results for respiratory viruses were obtained for all participants. Available blood and sputum cultures were analysed. A total of 165 elderly persons (mean age, 82+/-6.8 years) were hospitalised with a lower respiratory tract infection. Familial flu-like illness (OR, 4.25; 95%CI, 1.4-13), better functionality (OR, 4; 95%CI, 1.3-14.15), and leucocyte count <10(10)/l (OR, 3; 95%CI, 1.3-7.1) were predictive for viral lower respiratory tract infection. Sixty (36.5%) definite diagnoses (positive blood culture, viral culture, or serological test) and seven (4.2%) probable diagnoses (positive sputum culture) were obtained. An early diagnosis (within 72 h) was possible in 38 (23%) and a late diagnosis in 29 (17.6%) participants. A nasopharyngeal swab contributed in 60.5% of the cases to an early diagnosis. Viral culture identified half (22/43) of the lower respiratory tract infections caused by influenza but only one of six lower respiratory tract infections caused by respiratory syncytial virus. In conclusion, a history of flu-like illness in family members and a total leucocyte count within normal limits makes a viral cause more likely in elderly people hospitalised with a lower respiratory tract infection during winter. Viral culture and rapid antigen detection are insensitive in elderly patients hospitalised with a lower respiratory tract infection.
ISSN: 0934-9723
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Gerontology and Geriatrics
Laboratory of Clinical and Epidemiological Virology (Rega Institute)
Laboratory for Clinical Infectious and Inflammatory Disorders
Laboratory of Clinical Bacteriology and Mycology
× corresponding author
# (joint) last author

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