title: Tuberculosis in special populations.
abstract: The susceptibility to infection, the pathogenesis and the clinical manifestations of tuberculosis (TB) depend on the immunological status of the host. Immunological status is largely determined by age and comorbidities, but is also affected by other less well known factors. In Spain, most incidental cases of TB arise from the reactivation of remotely acquired latent infections and are favored by the aging of the population and the use of aggressive immunosuppressive therapies. The diagnosis and management of TB in these circumstances is often challenging. On the one hand, the atypical presentation with extrapulmonary involvement may delay diagnosis, and on the other, the toxicity and interactions of the antituberculous drugs frequently make treatment difficult. Immigration from resource-poor, high incidence TB countries, where the social and economic conditions are often suboptimal, adds a new challenge to the control of the disease in Spain. This chapter summarizes our current knowledge of epidemiological, clinical and treatment aspects of TB in particularly susceptible populations.
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge, IDIBELL, Departamento de Ciencias Clínicas, Universidad de Barcelona, Red Española de Investigación en Patología Infecciosa, Instituto de Salud Carlos III, Barcelona, Spain. msantin@bellvitgehospital.cat
authors.forename: Miguel
authors.initials: M
authors.lastname: Santín Cerezales
authors.forename: Enrique
authors.initials: E
authors.lastname: Navas Elorza
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004198:Disease Susceptibility; D054242:Emigrants and Immigrants; D005260:Female; D016330:Frail Elderly; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D007231:Infant, Newborn; D000069285:Infliximab; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D055985:Latent Tuberculosis / Q000453:epidemiology / Q000503:physiopathology; D008107:Liver Diseases / Q000453:epidemiology; D009169:Mycobacterium tuberculosis / Q000502:physiology; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D014180:Transplantation; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D035862:Vulnerable Populations
chemical_list: D000911:Antibodies, Monoclonal; D000995:Antitubercular Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab