Infection in long-term care residents

Background

• Often difficult to evaluate

Clinical Presentation

• Fever with temperature >37.8ºC (or repeatedly >37.2ºC, or >1.1ºC increase from baseline temperature)
• Hypothermia with two or more temperatures ≤36ºC or two or more temperatures with >1.1ºC decrease from baseline temperature
• Systolic BP ≤90 mmHg, or decrease in SBP by ≥40 mmHg
• Occasionally new-onset hyperglucemia
• Delirium, using the CAM criteria
• Symptoms that should not prompt assessment for infection include:
  • Behavioural changes other than delirium
  • Functional decline
  • Falls
  • Anorexia

Further Reading

• Reliability of nonlocalizing signs and symptoms as indicators of the presence of infection in nursing-home residents. Infect Control Hosp Epidemiol. 2020;1-10. doi: 10.1017/ice.2020.1282