Aging and Common Infections

Introduction:

Aging is associated with a reduction of immunity in the human body. As a result, the human body is susceptible to several types of infections. Proper diagnosis and management of these infections are necessary to lead a healthy life.

What Are the Common Bacterial Infections of the Elderly?

The common bacterial infections of older adults are;

1. Pneumonia: Pneumonia is the most common type of infection in older adults. The lower respiratory tract is the most commonly involved area in such cases. Pneumonia and influenza are the causes of 90 percent of deaths in older adults in the United States. Streptococcus pneumoniae is the most common causative organism associated with this. Pathogenic organisms responsible for such complications are Staphylococcus aureus and Acinetobacter baumannii. Aging changes in the respiratory tract include poor ventilation, less exchange of air in the alveoli, decreased mucociliary transport, decreased cough reflex, and decreased elasticity of alveoli. Susceptibility to infection increases during the winter season or season changes. The most common symptoms associated with respiratory infections are fever, cough, cold, difficulty breathing, heaviness in the chest, and drop of oxygen saturation in the blood. The risk factors for the development of such respiratory infections are;

2. Reduced immunity due to systemic disorders like diabetes.

3. Presence of comorbid disorders like liver failure, renal failure, and congestive cardiac diseases.

4. Previous history of smoking or vaping.

5. Previous history of pulmonary diseases like chronic obstructive pulmonary disorder, emphysema, or pulmonary tuberculosis.

6. A frequent history of hospitalization may increase susceptibility to nosocomial infections.

• Management: The most important factor for managing such conditions is taking precautions. Cessation of smoking and avoiding polluted environments can be useful to avoid lung infections. Apart from this, breathing exercises are useful to increase lung functionality. Application of antibiotics such as Azithromycin, Clarithromycin, or Levofloxacin are effective in such cases. The pneumococcal polysaccharide vaccine can be an excellent method of preventing lung pneumonia. Also, it can reduce mortality and hospitalization rates to a great extent. However, the efficacy of such vaccines is lower in immunocompromised patients.

What Are the Common Fungal Infections of Elderly People?

Fungal infections commonly affect the skin and the oral environment. These fungal infections are

1. Oral Candidiasis: This oral fungal infection is frequently observed in elderly individuals and is commonly referred to as oral thrush. The primary causative organism responsible for this condition is Candida albicans. Other organisms involved include Candida glabrata, Candida tropicalis, Candida kruesi, Candida guillermondii, and Candida lusitaniae. The most commonly affected areas are the ventral surface of the tongue, hard palate, soft palate, retromolar area, and mouth corners. Immunocompromised patients are particularly susceptible to this infection, often accompanied by diabetes and malnutrition. Poor oral hygiene, ill-fitting dentures, inhaler use, and radiation therapy are additional risk factors associated with this condition. The oral thrush lesion typically appears as a whitish area. However, in some cases, it may be erythematous or ulcerative and may cause bleeding. Patients commonly experience a burning sensation in the mouth, difficulty speaking, chewing, and bleeding from the affected area.

• Management: Topical antifungal medications like Miconazole, Clotrimazole, and Ketoconazole effectively treat this condition. Mouth rinses containing Betadine or Chlorhexidine can help enhance oral hygiene. Additionally, the use of multivitamins can aid in improving the patient's nutritional status.

2. Seborrheic Dermatitis: This is a prevalent skin disorder commonly observed in elderly individuals. The face and scalp are the most frequently affected areas in this condition. Apart from this, areas such as the eyebrows, glabella region of the forehead, nasal alar creases, nasolabial folds, and ear folds are commonly impacted. The affected area often presents symptoms of irritation, pain, and itching. In certain cases, hair loss and whitish flakes may be observed. Malassezia spp. is the commonly associated organism with this condition. The predominant species of Malassezia linked to seborrheic dermatitis are M. globosa and M. restricta. Other species, such as M furfur, M sympodialis, M obtuse, M slooffiae, and M pachydermatis, are also associated with this condition. These fungi contribute to the breakdown of fat in the sebaceous gland, leading to skin inflammation. The pathogenesis of this condition is associated with a decrease in the body's immunity. It is worth noting that seborrheic dermatitis is widespread among individuals suffering from AIDS.

• Management: Topical application of 2 percent Ketoconazole, 1 percent Ciclopirox, 1 percent Zinc pyrithione, and 1 percent hydrocortisone can be useful. Systemic application of Itraconazole, Fluconazole, and Terbinafine are indicated in severe cases.

What Are the Different Viral Infections in the Elderly?

1. Influenza: This is one of the most common viral infections affecting elderly people. This causes upper respiratory tract infection. The causative organisms are Haemophilus parainfluenzae and Haemophilus influenzae. The symptoms are similar to the upper respiratory tract infection along with fever. Such infections are related to season changes.

• Management: Anti-viral drugs like Amantadine, Rimantadine, Zanamivir, and Oseltamivir are used to treat influenza.

2. Herpes Infection: Herpes infection is another common infection in the elderly population. This type of viral infection is known for its latency period. However, in older individuals, reduced immunity is responsible for virus activation. Both Herpes simplex and Herpes zoster are responsible for oral and skin infections. In the oral region, it causes oral ulcers and sore throats. Ulcer in the corner of the mouth is this condition's most common side effect. In the skin, rashes along with macules can be observed. Cytomegalovirus is a beta herpes virus in nature. This type of viral infection causes alteration in the T-lymphocyte level. As a result, susceptibility to various infections is increased due to this type of viral infection. Also, it is associated with an increased risk of cardiovascular diseases.

• Management: Anti-viral antibiotics such as Famciclovir, Valacyclovir, and Acyclovir can be prescribed in such cases.

Conclusion:

Aging is related to changes in the physiological response of the body. As a result, a decrease in the body's immunity is observed. This causes various infections in elderly persons. Respiratory, urinary tract and skin infections are common among elderly people. Proper care should be taken to eradicate such issues.