Differences in clinical presentation of pulmonary tuberculosis in association with age.

OBJECTIVE To study the differences in presentation of pulmonary tuberculosis in young adult and elderly patients. DESIGN A prospective study was conducted between December 1999 to May 2000, which included all the patients presenting with pulmonary tuberculosis at the Department of Thoracic Medicine, Jinnah Postgraduate Medical Centre (JPMC), Karachi. PATIENTS AND METHODS There were 67 young adult (mean age 30.63 yrs) and 36 elderly patients (mean age 65.92 yrs) with pulmonary tuberculosis. The difference in presentation of two groups were analyzed for statistical difference. Chi-square test was used for testing difference of percentage. The students t-test was used for testing difference of mean. The P<0.05 level of significance was adopted. RESULTS The elderly patients were more likely to have dyspnoea (73% vs 23.9% P<0.001) and non-specific symptoms (62.2% vs 17.9% P<0.001) but less haemoptysis (21.6% vs 46.3% P<0.01). The chest radiograph in elderly patients more commonly had extensive bilateral infiltration (32.4% vs 14.9% P<0.03) and lower zone infiltration (37.8% vs 3% P<0.001). CONCLUSION The result of our study suggests that elderly patients with pulmonary tuberculosis were more likely to present with dyspnoea, non-specific symptoms and atypical radiographic appearance.