Features of pulmonary tuberculosis in elders

Abstract

Introduction. At elders pulmonary tuberculosis develops most often due to the reactivation of endogenous tuberculous infection, but the exogenous infection predisposes the reactivation of latent TB infection. Diagnosis difficulties and errors, as well as comorbidities and hospital care worsen epidemiological indices. Objective of the study. Assessment of clinical, paraclinical and treatment outcomes of pulmonary tuberculosis at elders. Material and methods. A retrospective, descriptive and selective study was realized on 95 new pulmonary tuberculosis elder patients is > 65 years old, treated in IMSF SMF during 2013 year. Results. Distrbution by sex reveald a non-significant predomination of men (71,7%) vs women (28,3% ). Case management established that the most of them were detected by passive way (68,5%), with an AFB positive smear only in 27,2% cases. Pulmonary infiltrative TB was diagnosed at 79,3%, fibrocavitary TB – 1,1% at and disseminated TB at - 17,4%, with parenchimal destructions at 37,5%, affecting both lungs in 31,5% cases. The most frequent clinical errors were bronchitic (26,8%) and pneumonic (19,6%) masks, that determined the transfer from somatic hospitals into pneumophtysiological services. Bacteriologicaly was identified positive results on conventional medium at 48,9% cases, with molecular-genetic positive test GeneXpert RIF at 30,4% cases. Treatment outcomes reflect the epidemiological situation of tuberculosis, so successfully treated were 67,4%, lost from follow up-5,4%, dead-9,8% cases. Conclusions. diagnosis difficulties and errors, expressed by high rate of passive detected cases and low rate of microscopic AFB identification demonstrates the epidemiological danger of elders patients, worsened by the medical care in other than phtysiopneumological services.