The effect of age on the presentation and outcome of tuberculosis in internal medicine

Objectives To compare the clinical, biochemical, radiological features and the outcome of elderly and young patients with tuberculosis. Methods Between 1980 and 1997, 83 patients diagnosed as having tuberculosis were treated in two departments of Internal Medicine and Geriatrics. They were divided into 42 young (< 65 years) and 41 elderly (greater than or equ al to 65 years) patients and differences in presentation between the two gr oups were analysed. Results A past history of tuberculosis was found in 10% of young and in 18% of elderly patients (p=0.43). Cancer was more often associated with tuberc ulosis in elderly patients (2% vs 15%, p=0.09). The sites of disease were s imilar in both groups with 2/3 of pulmonary infection. Comparison of the pr esenting symptoms showed no significant difference for weight loss (52% vs 66%, p=0.31), fever (52% vs 56%, p=0.90) and cough (33% vs 32%, p=1). The s kin testing was positive for the majority of the young adults (84% vs 58%, p=0.11). The commonly observed biochemical abnormalities in elderly patient s were an increased erythrocyte sedimentation rate (49 vs 69 mm/h: p=0.03) and lymphocytopenia (1724 vs 1059/mul, p <0.01). There was no significant d ifference in radiographic findings between both groups with miliary tubercu losis in about 10% of patients. During the first three months of treatment the mortality was especially high (22%) for the elderly patients. Conclusions Comparison of the clinical and radiological features of tubercu losis in internal medicine showed no significant difference in young and el derly patients.