A clinical profile of sputum positive pulmonary tuberculosis among elderly patients

The Pulmonary Tuberculosis has been known to mankind to cause increased morbidity and mortality especially in elderly. There is delay in diagnosis of pulmonary tuberculosis which led to increased mortality. Hence, this study looks into the pattern of presentations of the pulmonary tuberculosis and the radiological features that these patients demonstrate, which may help in early diagnosis and effective management.A cross-sectional, descriptive study was conducted on seventy patients above 60 years of age, who attended the outpatient department or those who were admitted in the geriatric ward of BLDE DU, Shri B. M. Patil Medical College, Hospital and Research Centre with symptoms suggestive of pulmonary tuberculosis over a period of twenty-four months irrespective of sex. The patients who tested sputum positive by ZN Stain for Mycobacterium Tuberculosis irrespective of primary diagnosis, defaulters and reactivation of pulmonary tuberculosis were included in the study group. In our study male predominance was seen with 48% of elderly in age group of 60-65 years. Majority (67%) of patients had typical features like fever, cough, evening rise of temperature while 32% had atypical symptoms like decreased appetite, increased thirst, weight loss and breathlessness. The common comorbid was Hypertension (10%). The most common radiological feature was miliary mottling (21%), while there was 11% mortality reported.This study being carried on elderly with sputum positive have given insight on the various pattern of clinical presentations and radiological features in elderly. Importance of sputum examination cannot be undermined in elderly and high degree of suspicion will help reach the diagnosis.

[1]  J. Ellner,et al.  Comparison of profile and treatment outcomes between elderly and non-elderly tuberculosis patients in Puducherry and Tamil Nadu, South India , 2021, PloS one.

[2]  M. Narita,et al.  Pulmonary Tuberculosis in Older Adults: Increased Mortality Related to Tuberculosis Within Two Months of Treatment Initiation , 2021, Drugs & Aging.

[3]  Ting-ting Xu,et al.  Population aging and trends of pulmonary tuberculosis incidence in the elderly , 2021, BMC Infectious Diseases.

[4]  O. Kon,et al.  Time to diagnosis of tuberculosis is greater in older patients: a retrospective cohort review , 2019, ERJ Open Research.

[5]  Nehal,et al.  Tuberculosis in elderly: The Indian perspective , 2018, International Journal of Advances in Medicine.

[6]  C. Leung,et al.  Epidemiological, clinical and mechanistic perspectives of tuberculosis in older people , 2018, Respirology.

[7]  I. Oh,et al.  Clinical characteristics and treatment outcomes of tuberculosis in the elderly: a case control study , 2013, BMC Infectious Diseases.

[8]  D. Biswas,et al.  Effect of age on presentation with diabetes: Comparison of nondiabetic patients with new smear-positive pulmonary tuberculosis patients , 2011, Lung India : official organ of Indian Chest Society.

[9]  O. Daniel,et al.  Treatment outcome of TB/HIV positive and TB/HIV negative patients on directly observed treatment, short course (DOTS) in Sagamu, Nigeria. , 2007, Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria.

[10]  J. Song,et al.  Diagnostic and Therapeutic Problems of Pulmonary Tuberculosis in Elderly Patients , 2005, Journal of Korean medical science.

[11]  C. Bolliger,et al.  Diagnostic tools in tuberculous pleurisy: a direct comparative study , 2003, European Respiratory Journal.

[12]  P. Murray,et al.  The acid-fast stain: a specific and predictive test for mycobacterial disease. , 1980, Annals of internal medicine.

[13]  World Health Organization, , 2003 .