La tuberculosis torácica y hematógena en pacientes de 75 a 100 años

Résumé

Summary: Authors have reported differences between tuberculosis in the elderly and younger adults. This situation is increased as senescence progresses. Therefore, we decided to study tuberculosis patients aged 75 and over.Methods: Retrospective study of 50 patients with thoracic tuberculosis or hematogenous between 75 and 100 years diagnosed in Bilbao between 2009 and 2013.Results: History of previous tuberculosis was present in 44% of patients. The most frequent comorbidities were COPD (38%), heart failure (36%), diabetes mellitus (24%), dementia (24%) and malignant neoplasms (20%). Main clinical presentations were pulmonary (60%), pleural (20%) and miliary (12%). The most common symptoms were cough (66%), sputum production (38%), fever (34%) and dyspnea (34%), being uncommon hemoptysis (10%). 42% of patients had old healed lesions ( in 54% of them was the only finding). Unilateral infiltrate was the most common lesion, slightly more prevalent in the upper lobes. Cavitation (6%) was rare. In 64% of cases the Zhiel / Auramine was negative. Resistant strains rate was very low. 40% of the patients died before the end of treatment, Death was directly attributed to tuberculosis in 50% of them. Hepatotoxicity was common resulting in death in one patient. We did not observe any bacteriological failure.Conclusion: Elderly patients showed differences in clinical features, radiology presentation and microbiological aspects compared to what is reported in younger patients, although treatment effectiveness remained satisfactory.