Comparison of pulmonary tuberculosis in younger and elderly patients.

Pulmonary tuberculosis remains a significant clinical and public health problem in the elderly population. To describe age-related differences in disease manifestations, a comparison of the clinical features, predisposing factors, diagnostic approaches and radiographic findings in cases of pulmonary tuberculosis among 52 young and 62 elderly patients was performed. The elderly patients had a higher number of underlying disease than younger patients (p less than 0.05). Prior to admission, symptoms occurring with equal frequency in both younger and elderly patients included coughing, malaise, and weight loss. Elderly patients had significantly higher incidences of negative reactions to the PPD test (p less than 0.05). Radiographic findings revealed that upper lung field infiltrates were still common in both groups, but the elderly had more severe lung field involvement (two or more lobes affected), and more frequent pleural reactions than younger patients (p less than 0.05). Since there were non-specific clinical features, false negative skin test and complex radiographic manifestations, tuberculosis was frequently not suspected in the differential diagnosis, especially among elderly patients with multiple medical problems. We suggest that physicians need to have a high level of suspicion and awareness of varied manifestations for tuberculosis, especially elderly patients.