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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

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