Spektrum tuberkulöser Erkrankungen in der pneumologischen Praxis

Hoheisel, Gerhard; Vogtmann, M.; Winkler, Jörg; Geßner, Christian; Hammerschmidt, Stefan; Seyfarth, HJ; Reimann, Silke; Rodloff, Arne C.; Gillissen, Adrian; Wirtz, Hubert

doi:10.1007/s00063-008-1120-1

Cited by 4 publications

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“…Die TB-Inzidenz nimmt bei in Deutschland Geborenen im hö-heren Lebensalter zu, bei im Ausland Geborenen kommt es neben zwei Häu-figkeitsgipfeln im Kindes-und jungen Erwachsenenalter zu einem dritten Gipfel bei den 60-bis 69-Jährigen (Abbildung 1) [3]. In einer kürzlich berichteten Studie war die TB mit einem Anteil von 0,5% aller in einer internistisch-pneumologischen Praxis betreuten Patienten ein seltenes Krankheitsbild, wobei der Anteil von Patienten > 69 Jahre 12% betrug [8]. In Japan wird geschätzt, dass in den Jahren 2010 bis 2020 mehr als 10 000 TB-Erkrankungen bei Menschen > 75 Jahre vorkommen werden.…”

Section: Inzidenz Und Infektionsrisikounclassified

Tuberkulose der Lunge und Pleura im Alter*

et al. 2009

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With the increase of the proportion of the elderly in the total population more cases of pulmonary and extrapulmonary tuberculosis (TB) are observed in this age group as well. Symptoms of TB are unspecific, often less apparent in the elderly, and may therefore cause a delay in the diagnostic process. A history of TB and comorbidities are more common in elder as compared to younger TB patients. The tuberculin skin test is less frequently positive. The interferon-gamma-release assay is complementary and together with clinical, radiologic, and bacteriologic test results helpful for the diagnosis or the exclusion of an active or latent TB infection. Medical treatment of TB in the elderly follows the established guidelines in the same way as for younger patients. The likelihood of drug-induced side effects and interactions with concomitant medications, however, is increased. Comorbidity and age-related immunosuppression may lead to a delay in the healing process. Higher age, comorbidity, and immunosuppression are predictors of an increased TB mortality. Even in a low-incidence country like Germany, TB should be recognized as an explanation for clinical symptoms particularly in the elderly patient group in order to allow an early diagnosis and therapy and thus a reduction of mortality and prevention of a further spread of this disease.

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Section: Inzidenz Und Infektionsrisikounclassified