J Korean Med Sci.  2005 Oct;20(5):784-789. 10.3346/jkms.2005.20.5.784.

Diagnostic and Therapeutic Problems of Pulmonary Tuberculosis in Elderly Patients

• Lee JH
• Han DH
• Song JW
• Chung HS

• KMID: 1781761
• DOI: http://doi.org/10.3346/jkms.2005.20.5.784

Abstract

To identify differences in the clinical, radiologic, and microbiologic features of pulmonary tuberculosis (TB) in the young (<64 yr) and elderly (> or =65 yr), we performed a retrospective analysis of the medical charts and chest radiographs of 207 young and 119 elderly pulmonary TB patients. Hemoptysis and a febrile sense were more frequent in the young, whereas weakness, dyspnea, anorexia, and mental change were more frequent in the elderly. Elderly patients showed higher frequencies of cardiovascular and chronic lung diseases, whereas the young showed a higher proportion of underlying liver disease. In addition, chest radiography showed a significantly higher frequency of mid or lower lung involvement by TB lesions in the elderly (10.6% vs. 22.7%, p<0.05). Lesions were frequently misdiagnosed as pneumonia or lung cancer in the elderly. However, there was no difference between these two groups in terms of sputum acid-fast bacilli positivity. The elderly showed a higher frequency of adverse drug reactions (18.5% vs. 40.7%, p<0.05), and higher TB-related mortality (1.3% vs. 11.1%, p<0.05). In conclusion this study showed that young and elderly pulmonary TB patients have similar microbiologic features; however, the elderly showed higher frequencies of atypical clinical and radiologic presentations, adverse drug reactions, and higher TB-related mortality.

Keyword

Aged; Tuberculosis; Symptom; Radiography; Microbiology; Diagnosis, Differential; Drug Reaction; Prognosis; Sputum

MeSH Terms

Adult
Aged
Aged, 80 and over
Antitubercular Agents/*therapeutic use
Comparative Study
Female
Humans
Incidence
Korea/epidemiology
Male
Middle Aged
Research Support, Non-U.S. Gov't
Retrospective Studies
Risk Assessment/*methods
Risk Factors
Survival Analysis
Survival Rate
Treatment Outcome
Tuberculosis, Pulmonary/*drug therapy/mortality/*radiography

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