Pattern of pulmonary tuberculosis in elderly patients in Sohag Governorate: Hospital based study

Abstract

Background: Tuberculosis (TB) in elderly is a worldwide problem. Objective: To evaluate differences in clinical, radiological, laboratory features, adverse antituberculosis drug reactions and TB-related mortality in elderly and young pulmonary TB patients. Results: The study included analysis of the medical history, chest radiographic and laboratory findings in 124 elderly and 124 young pulmonary TB patients, with mean age of 60.5 ± 9.1 and 31.6 ± 10.8 years, respectively (p < 0.0001), and comparable male predominance. There were higher frequencies of dyspnea, anorexia, weight loss, weakness and mental changes in elderly than young (p= 0.001, 0.004, < 0.0001, < 0.0001, 0.002, respectively) while there were higher frequencies of cough and sputum production, hemoptysis, and fever in young than elderly (p= 0.008, 0.01, 0.04, respectively) patients. Elderly had higher frequency of comorbidities (p < 0.0001). Elderly had higher frequency of atypical radiological findings for pulmonary tuberculosis and initial misdiagnosis as pneumonia and lung cancer (p < 0.0001, 0.001, 0.01, respectively). Elderly had a higher level of erythrocytic sedimentation rate (p = .01). Young had a higher frequency of positive sputum direct smear for acid fast bacilli (p = 0.04). Elderly had a higher role for fiberoptic bronchoscope in diagnosis of pulmonary TB (p = 0.001). There was a delay in the diagnosis of pulmonary TB in elderly (p < 0.0001) patients. Anti-tuberculosis drug side effects and TB-related mortality were more frequent in elderly (p < 0.0001, 0.03, respectively)patients. Conclusion: This study showed that elderly pulmonary TB patients had higher frequencies of atypically clinical, radiological presentations, co-morbidities, anti-tuberculosis drug adverse reactions and TB related mortality.

Keywords

• Tuberculosis
• Elderly
• Radiography
• Laboratory
• Antituberculosis drug