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Infections pulmonaires du sujet âgé aux urgences

Pneumonia in the elderly in the emergency department

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Les cahiers de l'année gérontologique

Résumé

La pneumopathie est fréquente chez le sujet âgé. Du fait de sa sémiologie souvent trompeuse avec notamment l’absence de signes spécifiques, la radiographie de thorax doit être pratiquée de façon assez large chez une personne âgée. La tachypnée doit être recherchée systématiquement. Les scores pronostiques aident à la décision de prise en charge ambulatoire ou hospitalière mais ne tiennent pas compte du contexte social. Le pneumocoque reste la cause la plus fréquente de pneumonie du sujet âgé, mais l’antibiothérapie initiale probabiliste doit aussi être active sur les bacilles à Gram négatif et les staphylocoques.

Abstract

Community-acquired pneumonia is frequent in the elderly. Because of its subtle clinical presentation, and atypical symptoms, chest radiography is recommended as part of the routine evaluations to establish the diagnosis for all patients. Tachypnea must be systematically researched. Prognostic scoring systems help to decide if hospitalization is necessary or not, but do not take the social context into account. Streptococcus pneumoniae is still the main pathogen identified in the elderly; however the initial empirical antibiotherapy must be active against Gram-negative bacilli and Staphylococcus species.

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Authors and Affiliations

  1. Service de gériatrie, centre hospitalier de la Pitié-Salpetrière, 47-83, boulevard de l’Hôpital, F-75013, Paris, France

    A. Breining

  2. Service de réanimation polyvalente, centre hospitalier d’Angoulême, Angoulême, France

    C. Cracco

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  1. A. Breining
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  2. C. Cracco
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Correspondence to A. Breining.

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Breining, A., Cracco, C. Infections pulmonaires du sujet âgé aux urgences. cah. année gerontol. 3, 56–61 (2011). https://doi.org/10.1007/s12612-011-0178-1

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  • DOI: https://doi.org/10.1007/s12612-011-0178-1

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