Clinical aspects of pulmonary tuberculosis in elderly patients from a university hospital in Rio de Janeiro, Brazil

• Published in: Jornal brasileiro de pneumologia Vol. 33; no. 6; pp. 699 - 706
• Main Authors: Cantalice Filho, João Paulo, Sant Anna, Clemax Couto, Bóia, Márcio Neves
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01.11.2007
• Subjects: Adolescent; Adult; Aged; Brazil - epidemiology; Chest Pain - epidemiology; Dyspnea - epidemiology; Epidemiologic Methods; Female; Fever - epidemiology; Hemoptysis - epidemiology; Hospitals, University; Humans; Male; Microscopy; Middle Aged; Mycobacterium tuberculosis - isolation & purification; Radiography; Sputum - microbiology; Time Factors; Tuberculosis, Pulmonary - diagnosis; Tuberculosis, Pulmonary - diagnostic imaging; Tuberculosis, Pulmonary - pathology; Weight Loss
• ISSN: 1806-3756

To evaluate clinical aspects and the diagnosis of pulmonary tuberculosis (PT) in the aged. We compared 117 patients over 60 years of age (elderly group) and 464 patients aged 15 to 49 years old (nonelderly group) treated at the Thoracic Diseases Institute of the Federal University of Rio de Janeiro, from 1980 to 1996. Previous history of PT was predominant in the elderly group (OR = 2.09; 95% CI = 1.26-3.45; p = 0.002), whereas household contact with PT was predominant in the nonelderly group (OR = 0.26; 95% CI = 0.10-0.66; p = 0.002). Mean time for diagnosis was 90 days in the elderly group and 60 days in the nonelderly group. In the elderly group, dyspnea (OR = 1.64; 95% CI = 1.06-2.53; p = 0.018) and weight loss (OR = 1.66; 95% CI = 1.01-2.82; p = 0.047) were predominant. In the nonelderly group, hemoptysis (OR = 0.51; 95% CI = 0.32-0.81; p = 0.002), chest pain (OR = 0.62; 95% CI = 0.40-0.97; p = 0.027) and fever (OR = 0.55; 95% CI = 0.35-0.86; p = 0.006) were more common. The most common radiological abnormalities were infiltrates and cavitations. Bilateral involvement was more common in the elderly patients (OR = 1.76; 95% CI = 1.12-2.78; p = 0.009). There were no differences between the two groups regarding positivity for Mycobacterium tuberculosis identified through tuberculin skin testing, sputum smear microscopy and culture. There are few clinical and laboratory differences between the age groups. The delayed diagnosis in the elderly group can be explained by the low clinical suspicion in these patients.