[Pathomorphism of tuberculous pleurisy in elderly and senile individuals].

The pathomorphism of tuberculous exudative pleurisy in elderly and senile individuals has been investigated in the past 30 years. Comparison of clinical, X-ray, laboratory, morphological, and immunological data in patients of the first (1978-1987) and second (1998-2007) periods has revealed the signs characteristic of the negative pathomorphism of the disease: progressive latency of tuberculous pleurisy and a lower Mantoux reaction, a lower detection rate for epithelioid giant-cell granulomas in the patients' biopsy specimens, a higher rate of pleural tuberculous inflammation, an increased frequency of comorbidity, a higher drug resistance rate in Mycobacterium tuberculosis, and decreased therapeutic efficiency. In this connection, elderly and senile persons with pleural effusion should be examined in a tuberculosis dispensary, with the bacteriological and morphological verification of the diagnosis being made. Their treatment should comprise the currently available antituberculous and pathogenetic agents.