Does pulmonary tuberculosis change with ageing?

SETTING

In most low prevalence countries, tuberculosis has become a disease of the aged; it has recently been suggested that the elderly may present a specific pattern.

OBJECTIVE

To compare clinical, bacteriological and radiological features of pulmonary tuberculosis between young and elderly populations in a high incidence country.

PARTICIPANTS AND

METHODS

We retrospectively studied 337 consecutive pulmonary tuberculosis patients without confirmed HIV infection, hospitalised from 1989 to 1993. The clinical, bacteriological and radiological features of the two age groups considered, young adults (< 60 years) and elderly (> or = 60 years), were compared.

RESULTS

Thoracic pain (16.3% vs 32.7%) and fever (27.2% vs 50.6%) were significantly less frequent in the elderly, while the frequency and duration of other symptoms before hospitalisation were similar. After admission, fever remained longer in young patients (P < 0.05). No significant differences were found regarding the general health status at hospitalisation, or associated illnesses (83.7% vs 73.5%; P = 0.068). Radiological lesions not related to the present diagnosis (14.1% vs 2.0%; P < 0.05), and a presumed diagnosis of tuberculosis (11.7% vs 4.1%; P = 0.02) were more frequent in the elderly.

CONCLUSION

This study showed no specific clinical, bacteriological or radiological features between age groups, and does not support the hypothesis of any age-related patterns in pulmonary tuberculosis.