Unsuspected tuberculosis in the aged

Fullerton, Jane M.; Dyer, Lori

doi:10.1016/s0041-3879(65)80062-9

Cited by 11 publications

(6 citation statements)

References 5 publications

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“…The need for bacteriological confirmation is stressed by the fact that symptoms such as fever, night sweats, cough, sputum production, and hemoptysis are less frequent in older patients with TB, 12,16 although they may actually be caused by other diseases like heart failure, pulmonary embolism, endocarditis, cancer and pneumonia, which are all common in this age group. 10 Among cases reported with negative sputum smears between 1986 and 1996, in less than 15% cultures were performed. This could have been related to the difficulty in obtaining specimens for examination or negligence on the part of health professionals.…”

Section: Diagnosis Is More Difficult Among Older Peoplementioning

confidence: 99%

“…Atypical symptomatology, difficulties in interpreting the tuberculin skin test, unusual radiological findings, and coexisting diseases or frequent alternative diagnoses often hinder the identification of TB before autopsy and contribute to the high mortality rates seen in this group. 6,10 As TB transmission is reduced during the epidemic progression in a particular region, the age group at greatest risk shifts gradually to older individuals since there is a drop in the annual risk of infection but not in the frequency of reactivation disease. 1 Vaccination with the bacillus CalmetteGuérin (BCG) and the increase in treatment efficacy, reducing the chronicity of the disease and therefore its transmission in the community, also tend to shift the incidence of TB to older age groups.…”

Section: Introductionmentioning

confidence: 99%

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Age transition of tuberculosis incidence and mortality in Brazil

Chaimowicz

2001

Rev. Saúde Pública

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ObjectiveBefore the Aids pandemic, demographic transition and control programs prompted a shift in the age of incidence of tuberculosis from adults to older people in many countries. The objective of the study is to evaluate this transition in Brazil. Methods Tuberculosis incidence and mortality data from the Ministry of Health and population data from the Brazilian Bureau of Statistics were used to calculate age-specific incidence and mortality rates and medians. Results Among reported cases, the proportion of older people increased from 10.5% to 12% and the median age from 38 to 41 years between the period of 1986 and 1996. The smallest decrease in the incidence rate occurred in the 30-49 and 60+ age groups. The median age of death increased from 53 to 55 years between 1980 and 1996. The general decline in mortality rates from 1986 to 1991 became less evident in the 30+ age group during the period of 1991 to 1996. A direct correlation between age and mortality rates was observed. The largest proportion of bacteriologically unconfirmed cases occurred in older individuals. ConclusionsThe incidence of tuberculosis has begun to shift to the older population. This shift results from the decline in the annual risk of infection as well as the demographic transition. An increase in reactivation tuberculosis in older people is expected, since this population will grow from 5% to 14% of the Brazilian population over the next 50 years. A progressive reduction in HIV-related cases in adults will most likely occur. The difficulty in diagnosing tuberculosis in old age leads to increased mortality. Resumo

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Section: Diagnosis Is More Difficult Among Older Peoplementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Age transition of tuberculosis incidence and mortality in Brazil

Chaimowicz

2001

Rev. Saúde Pública

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“…In a series of 21 cases of tuberculosis undiagnosed until autopsy, 15 were older than 65 years 4 . In 1965 Fullerton and Dyer 5 reviewed 1,713 post‐mortem examinations of patients over 70 in a London hospital. Of the 31 patients with active tuberculosis, the diagnosis was unsuspected at hospital admission in 27 and in 12 was made only at post‐mortem examination.…”

Section: Discussionmentioning

confidence: 99%

Addison's Disease from Tuberculosis in a Centenarian

Dedon

Courtney²,

Holmes³

1992

J American Geriatrics Society

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“…Tuberculosis is a sporadic disease in the older age groups (1). A 1.8 percent incidence of active tuberculosis has been found in a large series of autopsies on patients over 70 years of age (2). Unfortunately, the majority of these cases had been diagnosed either very late in the illness or after death.…”

Section: Age and Sex Age At Time Of First Episode (Yrs) X‐ray Findingsmentioning

confidence: 99%