The purpose of this study is to determine factors which predict a complicated hospital course and then to develop from these findings an Emergency Department guideline to assist in knowing who is at highest risk of elderly patients with infection presenting for care.

The study is looking at how closely physicians adhere to treatment guidelines in caring for elderly patients, and then to determine if there are differences in elderly patient disease symptoms that result in a failure to use guidelines. If this is known, physicians can then be aware of these differences and provide appropriate care.

Inclusion Criteria:

• age 65 or older
• blood cultures ordered in the Emergency Department
• admitted to the hospital from the Emergency Department

Exclusion Criteria:

• age less than 65
• prisoners
• Patient unable to provide consent and no legally authorized representative available
• non-English speaking
• ED visit or admission in the last 7 days for the same condition
• primary evaluation by the trauma team

Patients aged 65 or older who present to the Emergency Department with signs that could be consistent with infection