Razi Journal of Medical Sciences

  Background : Atypical clinical manifestations and radiologic images of pulmonary tuberculosis are common in elderly. To investigate the differences in the clinical, radiologic and laboratory features of pulmonary and pleural tuberculosis in older patients, as compared to younger patients.

  Methods: The medical records of patients with documented pulmonary tuberculosis in Rasoul-e-Akram hospital from 2005 through 2010 were analyzed. Data included sex, age, medical comorbidities, symptoms and signs, laboratory data, radiographic findings, tuberculin skin test (TST) and sputum smears and bronchoalveolar lavage (BAL) for AFB results. Statistical significances were analyzed by student t test and chi² test.

  Results: Among 285 patients with documented tuberculosis, 126 were 65 years of age and older, and 159 under 65 years of age. A lower prevalence of fever, night sweating, hemoptysis, anorexia, pleuritic chest pain, cavitary lesion in upper lobes, positive TST and positive acid fast bacilli in sputum and BAL were detected among older patients (p<0.05). In addition, the older patients had a greater prevalence of dyspnea (p<0.001) and some comorbidities, such as diabetes mellitus, COPD, and renal failure (p<0.05).

  Conclusion: This study showed the main differences of pulmonary tuberculosis in the elderly, compared to young patients that should be considered during the diagnostic assessment.