tailieunhanh - Diagnostic and Therapeutic Problems of Pulmonary Tuberculosis in Elderly Patients

To identify differences in the clinical, radiologic, and microbiologic features of pulmonary tuberculosis (TB) in the young (factors after initiation of anti-TB medication. Most importantly, the severe immunosuppression that characterizes the post-HSCTperiod may have a deleterious e¡ect on response to anti-TB treatment. In this study, we report on 2 childrenwho showed a di¡ering clinical course after treatment for pulmonaryTB diagnosed after allogeneic HSCT for acute lymphoblastic leukemia (ALL) | J Korean Med Sci 2005 20 784-9 ISSN 1011-8934 Copyright The Korean Academy ofMedical Sciences Diagnostic and Therapeutic Problems of Pulmonary Tuberculosis in Elderly Patients To identify differences in the clinical radiologic and microbiologic features of pulmonary tuberculosis TB in the young 64 yr and elderly 65 yr we performed a retrospective analysis of the medical charts and chest radiographs of 207 young and 119 elderly pulmonary TB patients. Hemoptysis and a febrile sense were more frequent in the young whereas weakness dyspnea anorexia and mental change were more frequent in the elderly. Elderly patients showed higher frequencies of cardiovascular and chronic lung diseases whereas the young showed a higher proportion of underlying liver disease. In addition chest radiography showed a significantly higher frequency of mid or lower lung involvement by TB lesions in the elderly vs. p . Lesions were frequently misdiagnosed as pneumonia or lung cancer in the elderly. However there was no difference between these two groups in terms of sputum acid-fast bacilli positivity. The elderly showed a higher frequency of adverse drug reactions vs. p and higher TB-related mortality vs. p . In conclusion this study showed that young and elderly pulmonary TB patients have similar microbiologic features however the elderly showed higher frequencies of atypical clinical and radiologic presentations adverse drug reactions and higher TB-related mortality. Key Words Aged Tuberculosis Symptom Radiography Microbiology Diagnosis Differential Drug Reaction Prognosis Sputum Jae Ho Lee Dae Hee Han Jae Woo Song Hee Soon Chung Division of Respiratory and Critical Care Medicine Department of Internal Medicine Department of Radiology Seoul National University College of Medicine Seoul Department of Radiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea Received 11 February 2005 Accepted 19 Arpil 2005 Address for .