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1994-08-09
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Document 0151
DOCN M9480151
TI Tuberculosis in young adults and the elderly. A prospective comparison
study.
DT 9410
AU Korzeniewska-Kosela M; Krysl J; Muller N; Black W; Allen E; FitzGerald
JM; Respiratory Division, Vancouver General Hospital, BC, Canada.
SO Chest. 1994 Jul;106(1):28-32. Unique Identifier : AIDSLINE MED/94291394
AB OBJECTIVES: To compare the clinical, bacteriologic, and radiologic
features of pulmonary and pleural tuberculosis in young adults and the
elderly and determine if any differences exist between both groups.
DESIGN: Prospective recruitment of all patients diagnosed as having
pulmonary and pleural tuberculosis in British Columbia, Canada. SETTING:
A population-based sample from a provincial control program TB registry.
PATIENTS: A total of 218 consecutive patients whose conditions were
diagnosed between January 1990 and May 1991. We excluded 15 HIV-positive
patients whose conditions were diagnosed during this study.
INTERVENTION: Standardized data collection of symptoms, bacteriology,
and review of radiology by two readers blind to the clinical and
epidemiologic data. MAIN RESULTS: There were 142 young adult patients
and 76 elderly patients. The young adults had a mean age of 41.2 years
and the elderly group had a mean age of 75 years of age. Fever (p =
0.002) and night sweats (p = 0.02) were more common in young adults. In
culture-proven disease, hemoptysis, fever, and cough were more common in
young adult (p = 0.03, 0.02, and 0.01, respectively). There was no
difference in the duration of symptoms between the two groups. The odds
ratio for cancers other than lung cancer, 3.98 (confidence interval,
1.49, 10.65) in the elderly group was the only significant risk factor
to differ between the two groups. Skin test responses to 5TU PPD were
positive in 86.2 percent of young adults and 67.6 percent of elderly
patients tested (p = 0.03). A total of 79.6 percent of young adults and
88.15 percent of the elderly patients (not significant) were culture
positive. Comparison of radiologic findings in young adults vs elderly
patients showed no significant differences apart from those with miliary
TB 0.7 percent vs 6.7 percent (p = 0.04). CONCLUSIONS: In this
population-based study, young adults were more likely to have
hemoptysis, fever, and cough and to have a positive PPD response. Cancer
was significantly associated as a risk factor in the older age group.
There was no difference in bacteriologically proven disease or
radiologic findings between the two groups, apart from the more common
occurrence of miliary TB in the elderly.
DE Adult Age Factors Aged Aged, 80 and over Comparative Study Human
Lung/RADIOGRAPHY Pleura/RADIOGRAPHY Prospective Studies Support,
Non-U.S. Gov't Tuberculin Test Tuberculosis,
Pleural/COMPLICATIONS/*DIAGNOSIS/RADIOGRAPHY Tuberculosis,
Pulmonary/COMPLICATIONS/*DIAGNOSIS/RADIOGRAPHY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).