Objectives: To compare the clinical.

Objectives: To compare the clinical, bacteriologic, and radiologic features of pulmonary and pleural tuberculosis in young adults and the somewhat old and determine if any differences exist between as well-as; not only-but also; not only-but; not alone-but 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 sway program TB registry.

Patients: A total of 218 consecutive patients whose conditions were diagnosed between January 1990 and May 1991 We exclud 15 HIV-positive patients whose conditions were diagnosed during this study

Intervention: Standardized data collection of symptoms, bacteriology, and review of radiology by dint of two readers blind to the clinical and epidemiologic data.

Main results: There were 142 young adult patients and 76 somewhat old patients. The young adults had a mean age of 412 years and the somewhat old group had a mean age of 75 years of age. heat (p=0.002) and night sweats (p=002) were more often met with in young adults. In culture-proven disease, hemoptysis, agitation and cough were more customary in young adult (p=0.03, 002 and 001 respectively). There was no difference in the duration of symptoms between the pair groups. The odds ratio for cancers other than lung cancer, 398 (confidence interval, 149 1065) in the somewhat advanced in life group was the only significant risk factor to differ between the sum of two units groups. Skin test responses to 5TU PPD were positive in 862 percent of young adults and 676 percent of somewhat old patients tested (p=0.03). A total of 796 percent of young adults and 8815 percent of the somewhat old patients (not significant) were refinement positive. Comparison of radiologic findings in young adults v somewhat advanced in life patients showed no significant differences apart from those with miliary TB 07 percent v 67 percent (p=004)

Conclusions: In this population-based application of mind young adults were more likely to have hemoptysis, flush and cough and to have a positive PPD answer Cancer was significantly associated as a risk factor in the older age assemblage There was no difference in bacteriologically proven disease or radiologic findings between the pair groups, apart from the more general occurrence of miliary TB in the elderly

CI=confidence interval;

IT=isolated tuberculoma;

LLZ=lower lung zone;

Tuberculosis (TB) is increasing in prevalence in North America.(1)(2) It is likely that infection with human immunodeficiency virus (HIV) is largely responsible for this increase(3)(4) and is also accounting for significant increases in developing countries.(5) Although infection with HIV is the single greatest risk factor for the evolution of TB,(6) the elderly are also particularly at high risk for the unfolding of disease,(7) as are aboriginal populations,(8) immigrants from high prevalence countries,(9) and the inner-city poor.(10) It has newly been suggested that TB in the somewhat old may differ from disease presenting in younger patients and that it should be classified as a separate entity.(11)(12) It has also been glance ated that these differences might account for a delay in diagnosis, which in move round leads to avoidable morbidity and mortality in this age group(13)(14)(15) We therefore decided to prospectively evaluate all cases of pulmonary and pleural TB diagnosed in British Columbia (BC) and compare the patterns of disease in young and antique patients. In BC, the overall rate through 100,000 in 1989 was 96 in the general population and 28/100000 in those aged more than 65 years.

METHODS

All cases of pulmonary and pleural TB reported to the Registry, Division of Tuberculosis have charge of Ministry of Health, BC, between January 1990 and May 1991 formed the application of mind group. The definition of active TB included disease prov according to isolation of Mycobacterium tuberculosis through culture from a patient and disease diagnosed through clinical and radiologic criteria with an appropriate rejoinder to therapy but without bacteriologic confirmation. The cases in which M tuberculosis was isolated are called "bacillary" in this article. The medical records were reviewed and in cases diagnosed in Vancouver the patients were interviewed. The primary care physician or public health nourish at the breast was asked to complete the standard data sheet in patients not seen in Vancouver. Data gathered include the following: demographic characteristics, history of previous TB symptoms, nearness of conditions predisposing to TB bacteriologic status at the time of diagnosis, follows of tuberculin test, results of histopathologic examinations, and therapy initiated. Adverse reactions were documented if they were reported as similar by the primary physicians and were further analyzed with regard to the ne to stop treatment with a particular drug

Bacteriologic investigations were done by dint of the Division of Laboratories, midmost point for Disease Control, Ministry of Health, BC This is the relation laboratory for mycobacteriology in BC and is a even 3 laboratory by the criteria of the American Thoracic Society. The tuberculin standard with 5 PPD TU was considered positive at a cut-point of 10 mm induration.

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