Acta
Medica Medianae
Vol. 42
No 3, Juli, 2003
UDK 61
YU ISSN 0365-4478
Kontakt:
Dr Milan Radović
Ulica Rentgenova 1a / 8
18 000 Niš,
Srbija i Crna Gora
Tel.: +381-18-65-20-35,
e-mail:
mradovic@bankerinter.net
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CHARACTERISTICS OF
TUBERCULOSIS (TB) IN GERIATRIC PATIENTS - INITIAL TREATMENT AND OUTCOME
Milan M. Radović,
Slavica N. Golubović,
Ivanka N.Đorđević,
Grozdana Pejović,
Milan H. Rančić,
Zoran P. Stamenković
Klinika za plućne bolesti i tuberkulozu, Klinički centar,
Niš
1090 TB pts were diagnosed and treated during the l992 - 2001. year (y).
227(20,8%) pts were older then 65. y, mean age of 73,5 - 1,5 y, with male /
female ratio of 57,3% / 42,7%. Most of them were farmers (44,9%) and retired
(37,4%). Most dominant symptoms were chronic cough (90, 3%), weight loss (83,
2%). 44,5% had positive tuberculin test. 87,7% were new cases, 11,8% defaulters
and 0,5% chronic cases (WHO criteria). Most concomitant diseases were diabetes
mellitus (19,8%), cardiac diseases (15,9%), while 3,5% had active malignancy.
Chest X-ray shown cavities in 41,4% pts, infiltrations in 29,9% and milliary
lesions in 3,9%. 30,4% lesions were atypical, while 60,8% pts had bilateral
fibrosis lesions. Extra pulmonary TB were in 9,7% pts, mostly on pleura (59,1%),
and kidney (13,6%). 41,4% treated with H, R, Z, S / E, 46,3% H, R, Z / E and
12,4% H, R, Z, S, E. 10,6% pts had liver function disturbances, 7,9% had allergy
on Z and 4,4% pts died. Conversion rate in only the culture positive pts were
faster and shown significance (p<0,05).
Histological verified TB |
Smear + (%) / conversion
rate (days) |
Culture + (%) / conversion
rate (weeks) |
Only on culture + (%) /
conversion rate (weeks) |
Mean duration of hospital
treatment (days) |
3,52 |
18,5 / 14,1- 5,31 |
38,32 / 4,12-1,43 |
20,7 / 2,34-0,31 (p<0,005) |
69,58-13,62 |
TB in the elderly has extended / latent clinical picture, atypical radiographic
localistaion, high frequency of concomitant diseases, demanding longer hospital
treatment. Fibrotic pulmonary lesions, atypical pulmonary infiltrations and
presence of concomitant diseases in elderly, must be alarm in future TB
screening.
Key words: tuberculosis in geriatric patients, initial treatment, outcome
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