Temperature/Infection Info

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http://freepages.health.rootsweb.com/~charmayn/symptom.html

" INFECTIONS - These are very serious in MSA patients and are often

overlooked because body temperature may not rise even when feverish. "

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http://www.bragmanhealth.com/books/aging/ch26.html

Aging and Health - See section on Infections

" Identifying Infection in an Older Person

Three basic principles help an older person or that person's caregiver to

suspect and recognize infection in the older person. First, infection may

cause an unexplained and rapid decline in ability to function or in a sense

of well-being. Second, serious infections will generally produce a fever.

Any elevated temperature in an older person requires very careful

evaluation. Finally, up to 20 to 30 percent of older people can have serious

infections such as pneumonia, urinary tract infections, an abscess in the

abdomen, or tuberculosis without manifesting fever.

While any bacteria, given the right conditions, can cause an infection,

different patterns of infection are seen in different settings. Recognition

of these patterns can be helpful in identifying the probable source of the

infection, especially in people with nonspecific symptoms.

In relatively healthy, functionally independent older people who live in

the community, the most frequently seen infections are respiratory

(influenza, bronchitis, and pneumonia), as well as urinary tract infections

and intraabdominal infections (bladder infections, diverticulitis,

appendicitis).

For people in the hospital, the major infections include urinary tract

infection, which is often related to use of a catheter; pneumonia caused by

aspiration; and skin and soft tissue infections such as infected pressure

ulcers and postoperative wounds. Blood clots in the lungs and medications

are also sources of fever in hospitalized older people.

When older people living in a nursing home are transferred to the

hospital, it is usually because of fever or suspected infection. Pneumonia,

urinary tract infection, and skin or soft tissue infection account for 70 to

80 percent of proven infections in this situation. Tuberculosis or

infectious diarrhea should also be considered when an older person living in

a nursing home appears to have an infection. "

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http://www.njneuro.org/movedis/msa.htm

" Shy-Drager Syndrome (SDS) has a predominance of autonomic disturbances, as

listed above including postural lightheadedness/fainting, impotence and

bowel and bladder dysfunction. Patients may also have dry mouth and skin,

abnormal sweating and difficulty regulating body temperature, sleep apnea

and problems with chewing, swallowing and breathing. "

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http://www.mc.vanderbilt.edu/gcrc/adc/msa.html

" Patients complain of impotence, change in writing style, slurred speech,

sleep apnea, difficulty with urination, frequent urinary tract infections, a

hoarse voice, passing out, headache, neck pain, dimming of vision and

yawning. "

" The most common causes of death in patients with MSA are pulmonary embolus,

apnea, and intercurrent infection. "

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http://www.mc.vanderbilt.edu/gcrc/adc/autonomic.html

" Some patients develop signs of neurogenic urinary retention and these

individuals may have repeated urinary tract infections in consequence. It

is noteworthy that patients with PAF do not usually have fevers as high as

healthy subjects; nevertheless, any fever will significantly lower their

blood pressure and consequently decrease their functional capacity. A sudden

decline in functional mobility in a patient with PAF is suggestive of an

intercurrent infection, usually of the urinary tract. A reduced basal

metabolic rate is typical. Evidence of normal sympathetic and

parasympathetic activity, such as nausea and pallor, may not occur when

expected. "