Gynecologic Sepsis as a Cause of Covert Infection in Old Age

Michael A. Horan, John Puxty, Roy Fox
In: Journal of the American Geriatrics Society · 1983 · vol. 31(4) , pp. 213–215 · doi:10.1111/j.1532-5415.1983.tb05098.x · PMID:6833698 · W2072206654
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This paper describes three elderly women with covert endometritis, suggesting menopause, aging-related immune decline, and malnutrition impair defenses against gynecologic sepsis.

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Abstract

Three cases of endometritis, which presented covertly in elderly women, are described. All three patients were in a poor state of nutrition, and two had serious intercurrent disease. It is believed that cyclical shedding of the endometrium and "normal" vaginal flora (under the influence of estrogen) are the major defenses against infection. These are lost after the menopause, and were therefore absent in the three patients described here. The waning of the immune response associated with aging, particularly the progesterone-stimulated uptake of polymeric IgA in the endometrium, may be important, as may the immunosuppressive effect of malnutrition. It is suggested that a nonspecific deterioration in an elderly woman or infection of uncertain site should prompt a careful re-examination, including a thorough pelvic examination.

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