DOES PULMONARY TUBERCULOSIS CHANGE WITH AGING

SETTING: In most low prevalence countries, tuberculosis has become a d isease of the aged; it has recently been suggested that the elderly ma y present a specific pattern. OBJECTIVE: To compare clinical, bacterio logical and radiological features of pulmonary tuberculosis between yo ung and elderly populations in a high incidence country. PARTICIPANTS AND METHODS: We retrospectively studied 337 consecutive pulmonary tube rculosis patients without confirmed HIV infection, hospitalised from 1 989 to 1993. The clinical, bacteriological and radiological features o f the two age groups considered, young adults (<60 years) and elderly (greater than or equal to 60 years), were compared. RESULTS: Thoracic pain (16.3% vs 32.7%) and fever (27.2% vs 50.6%) were significantly le ss frequent in the elderly, while the frequency and duration of other symptoms before hospitalisation were similar. After admission, fever r emained longer in young patients (P < 0.05). No significant difference s were found regarding the general health status at hospitalisation, o r associated illnesses (83.7% vs 73.5%; P = 0.068). Radiological lesio ns not related to the present diagnosis (14.1% vs 2.0%; P < 0.05), and a presumed diagnosis of tuberculosis (11.7% vs 4.1%; P = 0.02) were m ore frequent in the elderly. CONCLUSION: This study showed no specific clinical, bacteriological or radiological features between age groups , and does not support the hypothesis of any age-related patterns in p ulmonary tuberculosis.