Tuberculosis in chronic care homes.
Caucasian Canadians are in the tertiary phase of a 300-year tuberculosis epidemic. In this phase, the pattern of disease over the age spectrum is low in the young and middle-aged groups and rises to four times this rate in the elderly. The concentration of the elderly in chronic care homes (CCHs) magnifies the tuberculosis problem by increasing case rates another four times above the rate of elderly persons living separately, and 20 times above the overall Canadian rate. In spite of effective drugs with cure rates of over 95%, tuberculosis in the institutionalized elderly continues at an alarming rate. The difficulty lies in case finding. The prevailing attitude is that tuberculosis is no longer a problem. Surveillance programs are rudimentary. Between 35% and 40% of active cases in CCHs are the result of primary infection, mimicking bacterial pneumonia clinically and radiographically. In this target group of high-incidence tuberculosis, surveillance of residents is necessary, and the diagnosis needs to be considered in antibiotic-unresponsive pneumonia and in fever of unknown origin.
V H
VH
Hoeppner
E D
ED
Ring
Ann Intern Med. 1971 Apr;74(4):559-61
4994545
Clin Chest Med. 1980 May;1(2):231-41
6794976
Am Rev Respir Dis. 1965 Jun;91:811-22
14294702
Am Rev Respir Dis. 1973 Oct;108(4):799-804
4741874
N Engl J Med. 1985 Jun 6;312(23):1483-7
3990748
Am Rev Tuberc. 1958 Aug;78(2):151-72 contd
13559649
Am Rev Respir Dis. 1986 Jul;134(1):2-3
3729157
Am Rev Respir Dis. 1986 Aug;134(2):201-3
3017165
Clin Chest Med. 1980 May;1(2):243-52
6794977
Am Rev Respir Dis. 1985 Oct;132(4):735-6
3931520
Am Rev Respir Dis. 1967 May;95(5):729-45
4960690
J Am Geriatr Soc. 1983 Jun;31(6):356-63
6343467
J Infect Dis. 1980 Dec;142(6):946-8
7462706
Am Rev Respir Dis. 1985 Jul;132(1):133-6
4014857
Am Rev Respir Dis. 1979 Apr;119(4):587-97
109023