Stromberg B V
South Med J. 1985 Feb;78(2):157-8. doi: 10.1097/00007611-198502000-00009.
Diagnosis and management of hand infections in the elderly can be challenging. The general principles of rest, elevation, compresses, and drainage when appropriate apply. Antibiotics are important to therapy. Review of data from elderly patients and comparison with a younger population having identical infections show a number of important differences. Temperature, pulse, and white blood cell and differential counts were not elevated significantly enough to be useful. Culture data show fewer pure Staphylococcus aureus infections (20%) and fewer pure gram-positive infections (20%) than the 34% and 56% respectively in a younger population. On the other hand, there were significantly more mixed gram-positive and gram-negative infections (60%). Significantly, the average number of organisms per infection is increased (2.4 vs 1.9 per infection). Antibiotic susceptibility is significantly worse. The cephalosporins and the penicillinase-resistant antibiotics remain good choices.
老年手部感染的诊断和治疗颇具挑战性。适当采用休息、抬高、热敷及引流等一般原则。抗生素对治疗很重要。回顾老年患者的数据并与患有相同感染的年轻人群进行比较，发现了一些重要差异。体温、脉搏、白细胞及分类计数升高幅度不足，无显著诊断价值。培养数据显示，与年轻人群中分别为34%和56%的纯金黄色葡萄球菌感染（20%）和纯革兰氏阳性菌感染（20%）相比，老年患者中此类感染较少。另一方面，革兰氏阳性菌和革兰氏阴性菌混合感染显著增多（60%）。值得注意的是，每次感染的平均病原体数量增加（每次感染2.4种 vs 1.9种）。抗生素敏感性显著较差。头孢菌素类和耐青霉素酶的抗生素仍是不错的选择。
