XXXX in the elderly: diagnosis and management.

@entity1 @entity712 @entity730 @entity337 @entity299 @entity1856 @entity340 @entity884
@entity884 is seen with increasing frequency in older @entity1 . This increase is due to the general aging of the population, improved survival of @entity1 with @entity340 , and the increasing use of catheters and other prosthetic devices with resulting higher incidence of @entity884 . In older @entity1 , @entity884 frequently develops in the absence of underlying structural @entity299 ; @entity1856 and @entity730 are two important risk factors in this population. Infective organisms in older @entity1 are frequently enterococci and other gastrointestinal tract bacteria. A marked febrile response is uncommon whereas central nervous system symptoms are more common in older @entity1 . Transesophageal echocardiography can be performed safely and is a major diagnostic tool with sensitivity of more than 90% in detecting vegetations as small as 2-5 mm. Appropriately drawn blood cultures provide bacteriologic diagnosis in 80%-99% of patients. Prolonged antibiotic therapy may be required in many instances depending on the infective organism. Early surgical therapy is advisable for @entity1 who develop @entity712 as a result of severe @entity337 . Valve replacement surgery can be performed with acceptable mortality and morbidity even in very elderly @entity1 .
