Clinical features of pulmonary tuberculosis in young and elderly men.

A comparison of the clinical features, predisposing factors, side effects by antitubercular drugs and diagnostic procedures in pulmonary tuberculosis in 37 younger and 35 elderly men was carried out. Elderly patients had a higher number of underlying diseases including cardiovascular diseases and hypertension than younger patients. The classic symptoms and signs of tuberculosis, such as productive cough, fever and general fatigue, were observed in relatively high proportions of both patients, whereas weight loss (43% vs. 16%) and crackles in the lung fields (49% vs. 16%) were significantly higher in the elderly patients than the younger ones. As for roentgenographic abnormalities, a higher involvement of middle and lower lung fields was seen in the elderly patients than in the younger. Although leukocytosis was noted in a significantly lower proportion of the elderly patients, neutropenia due to drug treatment was significantly higher (23%) than in younger patients (5%). In a mass survey, the detection of pulmonary tuberculosis in elderly men was significantly lower (23%) than that in younger men (54%). Although improved living conditions, better sanitation and the development of new chemotherapeutic agents have contributed to the decline of pulmonary tuberculosis in general populations, better procedures for early detection or diagnosis of pulmonary tuberculosis in the elderly people should be achieved as soon as possible.