[Distinctive features of tuberculosis in the aged].
BACKGROUND
Current recrudescence of human tuberculosis is ascribed to HIV. Nevertheless, other at-risk individuals, particularly the elderly, have been reported.


METHODS
A retrospective study aimed at defining distinctive features of tuberculosis in the elderly was conducted. Eighty-two records of patients aged 18 to 64 years were compared to those of 58 patients of 65 years of age and over.


RESULTS
In the French area considered in this study, the elderly represent the most at-risk group. Institutionalization is a significant risk factor for tuberculosis (RR = 4). Despite a past history of tuberculosis and public awareness campaigns, first-intent diagnosis was evoked in only 22% of the older patients. The mean number of infectious localizations was higher in the elderly (1.3/patient) than in younger patients (1.1/patient). Results of tuberculin skin tests are unreliable. Prognosis is poor in the elderly. In the present study, 14 of the 18 encountered deaths occurred in the elderly, of which eight were due to tuberculosis.


CONCLUSIONS
To decrease the current incidence of tuberculosis, evaluations of preventive measures in the elderly should be validated and implemented, especially in institutionalized patients.
Roblot
F
F
Service de médecine interne-maladies infectieuses, CHU La Milétrie, Poitiers, France.
Roblot
P
P
Bourgoin
A
A
Pasdeloup
T
T
Underner
M
M
Meurice
J C
JC
Deveidex
P
P
Becq-Giraudon
B
B
D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*