Comparison of younger and elderly patients with pulmonary tuberculosis.

A comparison of the clinical features, predisposing factors, drug-induced adverse effects and diagnostic approach in pulmonary tuberculosis in 37 younger and 35 elderly men was carried out. Elderly patients had a higher number of underlying diseases, including cardiovascular diseases and hypertension, than younger patients. The classic symptoms and signs of tuberculosis, such as productive cough, fever and general fatigue, were observed in relatively high proportions of both patients, whereas weight loss (43 vs. 16%) and crackles in the lung fields (49 vs. 16%) were significantly higher in the elderly patients than the younger ones. As for roentgenographic abnormalities, a higher involvement of middle and lower lung fields was seen in the elderly patients than in the younger. Although leukocytosis was noted in a significantly lower proportion of the elderly patients, neutropenia due to drug treatment was significantly higher (23%) than in younger patients (5%). In a mass survey, the detection of pulmonary tuberculosis in elderly men was significantly lower (23%) than that in younger men (54%), suggesting that an extensive mass survey for pulmonary tuberculosis in elderly men should be done.