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Unformatted text preview: every year. The virulence factor of the pneumococcus is not an adhesin but the anti-phagocytic capsule: immunization raises protective anticapsular antibody. 1.2. Elderly patients By contrast, in elderly, debilitated patients, the pathogenesis is more like that in hospitalized patients, often including gram-negative bacilli, which colonize the nasopharynx and are aspirated into the lung.Nevertheless, the pathogens which affect healthier, younger, people can also affect the elderly. Frank episodes of gross aspiration tend to result in pneumonia caused by oral anaerobes (aspiration pneumonia). Such pneumonias often cavitate and produce putrid empyemas. 2. Two Important Pathogens In any patient with pneumonia, it is important to keep in the back of ones mind two unusual but important pathogens, namely, TB and Pneumocystis carinii....
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- Fall '10