Background and Objectives: Suspected bacterial infection is one of the leading presentations to the Emergency Department (ED) and is still associated with considerable morbidity and mortality. There is increasing evidence that biological sex may influence host immune responses, disease manifestations, therapeutic requirements, and clinical outcomes in infectious diseases. However, sex-specific differences among patients who present to the ED with suspected infection remain incompletely defined. This study, therefore, aimed to assess demographic characteristics, clinical presentation, and clinical management as well as short-term outcomes related to sex among these patients. Materials and Methods: Our single-center retrospective observational study included consecutive adults patients (n= 213) presented with suspected acute bacterial infection to the Emergency Department between June 2025 and August 2025. Results: Female patients were significantly older than male patients (72.13 ± 15.26 vs. 64.25 ± 13.66 years, p < 0.001). Cardiovascular disease and urinary tract infections were more frequently observed among women, whereas men presented significantly higher diastolic blood pressure values at admission (p = 0.004). Vasopressor therapy was more commonly required in female patients compared to males (26.0% vs. 13.3%, p = 0.019). No significant sex-related differences were identified regarding ICU admission or in-hospital mortality. Conclusions: ED patients with suspected bacterial infection demonstrate sex-related differences in age, comorbidities, infection source, and treatment requirements. Female patients were older and more frequently required vasopressor therapy. On the other hand, male patients had higher diastolic blood pressure and presented more frequently with respiratory infections. Short-term outcomes, including ICU admission and in-hospital mortality, were similar for both sexes. These findings highlight the importance of considering sex-specific characteristics in the early assessment and management of suspected infection in the Emergency Department.

Background and Objectives: Suspected bacterial infection is one of the leading presentations to the Emergency Department (ED) and is still associated with considerable morbidity and mortality. There is increasing evidence that biological sex may influence host immune responses, disease manifestations, therapeutic requirements, and clinical outcomes in infectious diseases. However, sex-specific differences among patients clinically managed for suspected bacterial infection in ED remain incompletely defined. This study, therefore, aimed to assess demographic characteristics, clinical presentation, and clinical management as well as short-term outcomes related to sex among these patients. Materials and Methods: This retrospective single-center observational study included consecutive adults presenting with suspected bacterial infection to the ED between 1 June and 31 August 2025. Demographic, clinical, laboratory, treatment, infection-source, and outcome data were extracted from medical records. Between-group comparisons were followed by planned age-adjusted analyses and multivariable logistic regression. Results: A total of 213 patients were included, comprising 100 women (46.9%) and 113 men (53.1%). Women were older than men (median 77.0 vs. 67.0 years, p < 0.001), had lower diastolic blood pressure (70 vs. 75 mmHg, p = 0.004), and lower hemoglobin concentrations (11.79 vs. 12.45 g/dL, p = 0.004). Cardiovascular disease was more frequent among women than men (72.0% vs. 52.2%, p = 0.003), although this difference was attenuated and no longer significant after adjustment for age. A documented urinary source of infection was more frequent among women (51.0% vs. 34.5%, p = 0.015) and remained significantly associated with female sex after age adjustment (OR 2.14, 95% CI 1.20–3.81, p = 0.010; Benjamini–Hochberg-adjusted p = 0.039). No significant difference was detected in Emergency Department treatment: supplemental oxygen, vasopressors and broad-spectrum antibiotics were given with similar frequency to women and men (all p ≥ 0.139). Direct intensive care unit (ICU) admission from the ED occurred in 14 of 100 women (14.0%) and 21 of 113 men (18.6%; OR 0.71, 95% CI 0.34–1.49), and in-hospital mortality in 7 women (7.0%) and 9 men (8.0%; OR 0.87, 95% CI 0.31–2.43). After adjustment, female sex was not independently associated with direct ICU admission (OR 0.64, 95% CI 0.29–1.39; p = 0.257) or in-hospital mortality (OR 0.80, 95% CI 0.27–2.35; p = 0.690). Conclusions: In this single-center retrospective cohort of adults clinically managed for suspected bacterial infection in the emergency department, women were older and more frequently had a documented urinary source of infection. After adjustment for age, female sex remained associated with a documented urinary source of infection. The study did not provide precise evidence that sex was independently associated with direct ICU admission or in-hospital mortality; however, the confidence intervals were wide and clinically relevant differences cannot be excluded. Larger prospective multicenter studies with standardized diagnostic criteria, microbiological confirmation, and adequate outcome-event numbers are needed.