Natural enemy or friend? Pneumonia in the very elderly critically ill patient

Pneumonia has been a serious cause of morbidity and mortality for many years and, more than 100 years ago, Sir William Osler referred to it as "the natural enemy of the old man" [1]. Many studies have documented that elderly individuals have a higher frequency of illness, increased mortality and more subtle clinical features compared to younger populations. This too was known by Osler who commented that "it is not improbable that debility lowers the vitality and renders the individual susceptible" and when the illness occurs, it can be "without chill; the cough and expectoration are slight" and the physical findings non-specific [1]. He noted that while fever was not usually prominent, patients often had altered mental status and that pneumonia could precipitate congestive heart failure [1].
Source: European Respiratory Review - Category: Respiratory Medicine Authors: Tags: Epidemiology, occupational and environmental lung disease, Respiratory infections and tuberculosis Editorial Source Type: research