Community-acquired bacteremic urosepsis in the elderly patients: a prospective study of 34 consecutive episodes.

A prospective study was done on the clinical, laboratory, radiological, immunological and therapeutic features of acute, symptomatic, bacteremic urosepsis in 34 consecutive, elderly patients who required hospitalization. Urinary tract infection was identified as the most common cause of gram-negative bacteremia in elderly patients admitted to a community hospital. Appropriate antibiotic therapy and a lack of serious associated medical illnesses contributed to the high survival rate. Bacteremia and shock occurring in the wake of pyelonephritis develop more commonly in elderly than in young women. In the elderly patient with bacteremia and pyelonephritis radiographic evaluation invariably demonstrates obstruction to urine flow, calculous disease or abscess. Guidelines are provided for the therapy of acute, symptomatic bacteremic urosepsis.