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