Clinical and Radiographic Manifestations and Treatment Outcome of Pulmonary Tuberculosis in the Elderly in Khuzestan, Southwest Iran

BACKGROUND: Presentation of pulmonary tuberculosis (PTB) in the elderly is expected to be different from that in younger patients because of the debilitating factors and comorbidities. This issue should be considered in the national tuberculosis programs of countries. The purpose of this study was to evaluate the differences in the clinical and radiographic manifestations and treatment outcomes of PTB between the elderly and young patients. MATERIALS AND METHODS: This study was conducted as part of a mega project on tuberculosis by the Infectious and Tropical Diseases Research Centre affiliated to Ahvaz Jundishapur University of Medical Sciences. We retrospectively analyzed the medical records of 2,080 relatively young (18–64 years old at the time of diagnosis) and 346 elderly (≥65 years) PTB patients, who had been recently diagnosed and treated in the TB unit of Khuzestan Health Center from 2005 to 2010. RESULTS: Dyspnea and hemoptysis were the most common symptoms and the frequency of positive sputum smear –AFB was lower in the elderly PTB patients. On chest X-ray, elderly patients were less likely to have cavitation in comparison with younger patients. The frequency of favourable treatment outcome in the elderly was significantly lower than that in younger patients (64% vs. 77%, P = 0.003). CONCLUSION: Dyspnea, weight loss and hemoptysis were more common in the elderly PTB patients. Chest X-ray showed less frequent typical findings of active PTB such as cavitation; and microscopic examination showed fewer sputum smear AFB positive cases in the elderly. The treatment outcome was less favorable in the elderly compared to younger TB patients.