Rajagopalan S
Department of Internal Medicine, Division of Infectious Disease, Charles R. Drew University of Medicine and Science, Martin Luther King, Jr./Drew Medical Center, Los Angeles, CA 90059, USA.
Clin Infect Dis. 2001 Oct 1;33(7):1034-9. doi: 10.1086/322671. Epub 2001 Aug 22.
Despite the World Health Organization's declaration that the spread of tuberculosis is a global emergency and despite the implementation of strong tuberculosis-control initiatives, this highly infectious disease continues to affect all vulnerable populations, including the elderly population (age > or =65 years). Tuberculosis in aging adults remains a clinical and epidemiological challenge. Atypical clinical manifestations of tuberculosis in older persons can result in delay in diagnosis and initiation of treatment; thus, unfortunately, higher rates of morbidity and mortality from this treatable infection can occur. Underlying illnesses, age-related diminution in immune function, the increased frequency of adverse drug reactions, and institutionalization can complicate the overall clinical approach to tuberculosis in elderly patients; maintenance of a high index of suspicion for tuberculosis in this vulnerable population is, thus, undoubtedly justifiable.
尽管世界卫生组织宣布结核病的传播是全球紧急情况，尽管实施了强有力的结核病控制举措，但这种高传染性疾病仍继续影响所有弱势群体，包括老年人群（年龄≥65岁）。老年成人结核病仍然是临床和流行病学上的一项挑战。老年人结核病的非典型临床表现可能导致诊断和治疗开始的延迟；因此，不幸的是，这种可治疗感染导致的发病率和死亡率可能更高。基础疾病、与年龄相关的免疫功能减退、药物不良反应频率增加以及机构化会使老年患者结核病的整体临床处理变得复杂；因此，在这一弱势群体中对结核病保持高度怀疑指数无疑是合理的。
