Changing pattern of lung tuberculosis.

In 46 (20%) of 233 consecutive patients with active lung tuberculosis, the localization of the tuberculous process was unusual. The majority of patients (81%) were greater than 40 years of age. Men predominated in the usual localized tuberculosis group, whereas women predominated in the group with unusual localized tuberculosis (UNLT). The most common site of tuberculosis in the UNLT group was the anterior segment of the upper lobe or the middle lobe. In 17.5% of the patients in the UNLT group, the diagnosis was established by thoracotomy only. In patients with "protracted pneumonia," or chest X-ray suggestive of neoplastic disease, tuberculosis should be included in the differential diagnosis, irrespective of the site of the lesion.