Wurbs W
Z Erkr Atmungsorgane. 1984;162(3):227-43.
The problem of quick and early detection of tuberculosis in old persons deserving increasingly special attention is discussed by the hand of eight observations. Differential diagnosis of generalized forms and isolated extrapulmonary organ tuberculosis is particularly difficult. Incorrect interpretation of signs and symptoms, default of examinations crucial for right diagnosis and above all, not considering tuberculosis in the diagnostic process explain error and often subsequent death due to failing the diagnosis of tuberculosis. In the examples represented the difficulties in making the right diagnosis, the change of the clinical features and course of disease, and the reasons for misinterpretation of these forms are shown. Relevant conditions and diagnostic procedures referring to the diagnosis of tuberculosis in old people are reviewed as chronic disabling ailments, drugs reducing resistance, pulmonary fibrotic lesions all sometimes followed by exacerbation of pulmonary or lymph node tuberculosis and subsequent haematogenous generalization, and as the tuberculin testing and repeated examinations for tubercle bacilli.
通过八个病例探讨了老年人结核病快速早期检测这一愈发值得特别关注的问题。全身性结核病与肺外器官孤立性结核病的鉴别诊断尤为困难。对体征和症状的错误解读、缺乏对正确诊断至关重要的检查，尤其是在诊断过程中未考虑结核病，这些因素导致诊断失误，并常常因未能诊断出结核病而导致患者死亡。在所列举的病例中，展示了正确诊断的困难、临床特征和病程的变化，以及对这些病症错误解读的原因。文中回顾了与老年人结核病诊断相关的情况和诊断程序，如慢性致残性疾病、降低抵抗力的药物、肺部纤维化病变（有时随后会出现肺结核或淋巴结结核加重及血行播散），以及结核菌素试验和反复检测结核杆菌。
