Skip to main content

Advertisement

Log in

Age-Related Changes in the Manifestations of Tuberculosis

Implications for Drug Therapy

  • Review Article
  • Epidemiology
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Summary

Although the overall number of tuberculosis cases reported in developed countries has decreased markedly since about the middle of the twentieth century, at present active tuberculosis in the geriatric population is highly prevalent even in developed countries. With an increase in the aged population and striking progress in medicine during the past two decades, the development of tuberculosis infections and the active disease has been gradually changed; namely, the number of older people at risk of infection has been increasing. In the elderly, postprimary pulmonary tuberculosis and miliary tuberculosis are particularly difficult to diagnose. A high index of suspicion, a tuberculin skin test, and appropriate laboratory studies are essential for early diagnosis. In choosing the proper therapy for tuberculosis in the elderly, efficacy, patient compliance, and toxicity must be considered. During this decade, more so than ever before, much time and work will be required to more completely understand the factors that place a patient at risk for infection and to accomplish eradication of tuberculosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Addington WW. The side effects and interactions of anti-tuberculosis drugs. Chest 76: 782–784, 1979

    PubMed  CAS  Google Scholar 

  • Alford RH. Antimycobacterial agents. In Mandell et al. (Eds) Principles and practice of infectious diseases, 3rd ed., pp. 350–360, Churchill Livingston Inc., New York, 1990

    Google Scholar 

  • Alvarez S, Shell C, Berk ST. Pulmonary tuberculosis in elderly men. American Journal of Medicine 82: 602–606, 1987

    Article  PubMed  CAS  Google Scholar 

  • American Thoracic Society. Treatment of tuberculosis in alcoholic patients. American Review of Respiratory Disease 116: 559–561, 1977

    Google Scholar 

  • American Thoracic Society. Treatment of tuberculosis and tuberculosis infection in adults and child. American Review of Respiratory Disease 134: 355–363, 1986

    Google Scholar 

  • Banyai AL. Pulmonary tuberculosis in the aged. American Review of Tuberculosis 21: 568–578, 1920

    Google Scholar 

  • Battershill JH. Cutaneous testing in the elderly patient with tuberculosis. Chest 77: 188–189, 1980

    Article  PubMed  CAS  Google Scholar 

  • Bobrowitz ID. Ethambutol compared to rifampin in original treatment of pulmonary tuberculosis. Lung 157: 117–125, 1980

    Article  PubMed  CAS  Google Scholar 

  • Butterworth AE, David JR. Eosinophil function. New England Journal of Medicine 304: 154–156, 1981

    Article  PubMed  CAS  Google Scholar 

  • Centers for Disease Control. Adverse drug reactions among children treated for tuberculosis. Morbidity and Mortality Weekly Report 29: 589–591, 1980

    Google Scholar 

  • Chaisson RE, Schecter GF, Theuer CP, Rutherford GW, Echenberg DF, et al. Tuberculosis in patients with the acquired immunodeficiency syndrome: clinical features, response to therapy, and survival. American Review of Respiratory Disease 136: 570–574, 1987

    Article  PubMed  CAS  Google Scholar 

  • Comstock GW. Epidemiology of tuberculosis. American Review of Respiratory Disease 125(3 Pt 2): 8–15, 1982

    PubMed  CAS  Google Scholar 

  • Comstock GW, Livesaf VT, Woolpert SF. The prognosis of a positive tuberculin reaction in childhood and adolescence. American Journal of Epidemiology 99: 131–138, 1974

    PubMed  CAS  Google Scholar 

  • Dasta JF, Prior JA, Kurzrok S. Isoniazid-induced fever. Chest 75: 196–197, 1979

    Article  PubMed  CAS  Google Scholar 

  • Davies BH. Infectivity of tuberculosis. Thorax 35: 481–482, 1980

    Article  PubMed  CAS  Google Scholar 

  • Des Prez RM, Heim CR. Mycobacterium tuberculosis. In Mandell et al. (Eds) Principles and practice of infectious diseases, 3rd ed., pp 1877–1906, Churchill Livingstone Inc., New York, 1990

    Google Scholar 

  • Dinarello CA, Wolff SM. Fever of unknown origin. In Mandell et al. (Eds) Principles and practice of infectious diseases, 3rd, ed., pp 468–479, 1990

    Google Scholar 

  • Di Perri G, Cruciani M, Danzi MC, Luzzati R, De Checchi G, et al. Nosocomial epidemic of active tuberculosis among HIV-infected patients. Lancet 2: 1502–1504, 1989

    PubMed  Google Scholar 

  • Dorken E, Grzybowski S, Allen EA. Significance of the tuberculin test in the elderly. Chest 92: 237–240, 1987

    Article  PubMed  CAS  Google Scholar 

  • Editorial. World tuberculosis. Lancet 1: 689–691, 1965

  • Enarson DA, Grzybowski S. Incidence of active tuberculosis in the native population of Canada. Canadian Medical Association Journal 134: 1149–1152, 1986

    PubMed  CAS  Google Scholar 

  • Farer LS, Lowell LM, Meador MP. Extrapulmonary tuberculosis in the United States. American Journal of Epidemiology 109: 205–217, 1979

    PubMed  CAS  Google Scholar 

  • Fraser RG, Paré JAP, Paré PD, Fraser RS, Genereux GP (Eds). Diagnosis of diseases of the chest, 3rd ed., WS Saunders Company, Philadelphia, 1989

    Google Scholar 

  • Freeman JT, Heiken CA. The geriatric aspect of pulmonary tuberculosis. American Journal of the Medical Sciences 202: 29–38, 1941

    Article  Google Scholar 

  • Girling DJ, Hitze KL. Adverse reactions of rifampicin. Bulletin of the World Health Organization 57: 45–49, 1979

    PubMed  CAS  Google Scholar 

  • Glassroth J, Robbins AG, Snider Jr DE. Tuberculosis in the 1980s. New England Journal of Medicine 302: 1441–1450, 1980

    Article  PubMed  CAS  Google Scholar 

  • Goldman AL, Braman SS. Isoniazid: A review with emphasis on adverse effects. Chest 62: 71–77, 1972

    Article  PubMed  CAS  Google Scholar 

  • Grzybowski S. Ontario studies on tuberculin sensitivity. Canadian Journal of Public Health 56: 181–192, 1965

    CAS  Google Scholar 

  • Grzybowski S. The impact of treatment programs on the epidemiology of tuberculosis. Tubercle 66: 69–72, 1985

    Article  PubMed  CAS  Google Scholar 

  • Grzybowski S, Allen EA. The challenge of tuberculosis in decline: a study based on the epidemiology of tuberculosis in Ontario, Canada. American Review of Respiratory Disease 90: 707–720, 1964

    PubMed  CAS  Google Scholar 

  • Hadlock FP, Park SK, Awe RJ. Rivera M. Unusual radiographic findings in adult pulmonary tuberculosis. American Journal of Roentgenology 134: 1015–1018, 1980

    PubMed  CAS  Google Scholar 

  • Hong Kong Tuberculosis Treatment Services/British Medical Research Council. Adverse reaction to short-course regimens containing streptomycin, isoniazid, pyrazinamide and rifampicin in Hong Kong. Tubercle 57: 81–95, 1976

    Article  Google Scholar 

  • Hopewell PC. Mycobacterial diseases. In Murray and Nadel (Eds) Textbook of respiratory medicine, pp. 856–915, WS Saunders Company, Philadelphia, 1988

    Google Scholar 

  • Jacobson HG, Shapiro JH. Pulmonary tuberculosis. Radiologic Clinics of North America 1: 411–427, 1963

    Google Scholar 

  • Johnston RN, Ritchie RT, Murray HF. Declining tuberculin sensitivity with advancing age. British Medical Journal 2: 720–724, 1963

    Article  PubMed  CAS  Google Scholar 

  • Joress MH. Pulmonary tuberculosis in old people. New England Journal of Medicine 219: 885–887, 1938

    Article  Google Scholar 

  • Katz I, Rosenthal T, Michaeli D. Undiagnosed tuberculosis in hospitalized patients. Chest 87: 770–774, 1985

    Article  PubMed  CAS  Google Scholar 

  • Khan MA, Kovnat DM, Bachus B, Whitcomb ME, Brody JS, et al. Clinical and roentgenographic spectrum of pulmonary tuberculosis in the adult. American Journal of Medicine 62: 31–38, 1977

    Article  PubMed  CAS  Google Scholar 

  • Kopanoff DE, Snider Jr DE, Caras GJ. Isoniazid-related hepatitis. A US Public Health Service cooperative surveillance study. American Review of Respiratory Disease 117: 991–1001, 1978

    PubMed  CAS  Google Scholar 

  • Kurihara T, Aoki M. Surveillance of tuberculosis (in Japanese). Kekkaku 57: 613–635, 1982

    Google Scholar 

  • Lester W. Rifampicin: a semisynthetic derivative of rifampicin — a prototype for the future. Annual Review of Microbiology 26: 85–102, 1972

    Article  PubMed  CAS  Google Scholar 

  • Mahmoud AAF, Stone MK, Kellermeyer RW. Eosinophilopoietin: a circulating low molecular weight peptide-like substance which stimulates the production of eosinophils in mice. Journal of Clinical Investigation 60: 675–682, 1977

    Article  PubMed  CAS  Google Scholar 

  • Mann J, Snider DE, Francis H, Quinn TC, Colebunders RL, et al. Association between HTLV-III/LAV infection and tuberculosis in Zaire. Journal of the American Medical Association 256: 346, 1986

    Article  PubMed  CAS  Google Scholar 

  • McAdam JM, Brickner PW, Scharer LL, Crocco JA, Duff AE. The spectrum of tuberculosis in a New York City Men’s Shelter Clinic (1982-1988). Chest 97: 798–805, 1990

    Article  PubMed  CAS  Google Scholar 

  • Medical Research Council Tuberculosis and Chest Disease Unit. National survey of tuberculosis notifications in England and Wales 1978–9. British Medical Journal 281: 895–898, 1980

    Article  Google Scholar 

  • Medical Research Council Tuberculosis and Chest Disease Unit. National survey of notifications of tuberculosis in England and Wales in 1983. British Medical Journal 291: 658–661, 1985

    Article  Google Scholar 

  • Mitchell JR, Zimmerman HJ, Ishak KG. Thorgeirsson UP, Timbrell JA, et al. Isoniazid liver injury: clinical spectrum, pathology, and probable pathogenesis. Annals of Internal Medicine 84: 181–192, 1976

    PubMed  CAS  Google Scholar 

  • Nagami PH, Yoshikawa TT. Tuberculosis in the geriatric patient. Journal of the American Geriatrics Society 31: 356–363, 1983

    PubMed  CAS  Google Scholar 

  • National Consensus Conference on Tuberculosis. Standard therapy for tuberculosis 1985. Chest 87 (Suppl.): 117s–124s, 1985

    Google Scholar 

  • Nichols GP. Diabetes among young tuberculosis patients: a review of the association of the two diseases. American Review of Tuberculosis and Pulmonary Diseases 76: 1016–1030, 1957

    CAS  Google Scholar 

  • Patel KR. Pulmonary tuberculosis in residents of lodging houses, night shelters and common hostels in Glasgow: a 5-year prospective survey. British Journal of Diseases of the Chest 79: 60–66, 1985

    Article  PubMed  CAS  Google Scholar 

  • Pitchenik AE, Cole C, Russell BW, Fischl MA, Spira TJ, et al. Tuberculosis, atypical mycobacteriosis, and the acquired immunodeficiency syndrome among Haitian and non-Haitian patients in South Florida. Annals of Internal Medicine 101: 641–645, 1984

    PubMed  CAS  Google Scholar 

  • Powell KE, Farer LS. The rising age of tuberculosis patients: a sign of success and failure. Journal of Infectious Disease 142: 946–948, 1980

    Article  CAS  Google Scholar 

  • Rahajoe NN, Rahajoe N, Boediman I, Said M, Lazuardi S. The treatment of tuberculosis meningitis in children with a combination of isoniazid, rifampicin and streptomycin. Preliminary report. Tubercle 60: 245–250, 1979

    Article  PubMed  CAS  Google Scholar 

  • Sanders Jr WE. Rifampin. Annals of Internal Medicine 85: 82–86, 1976

    PubMed  CAS  Google Scholar 

  • Sarma GR, Immanuel C, Kailasam S, Narayana ASL, Venkatesan P. Rifampicin-induced release of hydrazine from isoniazid: a possible cause of hepatitis during treatment of tuberculosis with regimens containing isoniazid and rifampicin. American Review of Respiratory Disease 133: 1072–1075, 1986

    PubMed  CAS  Google Scholar 

  • Segarra F, Sherman DS, Rodriguez-Aguero J. Lower lung field tuberculosis. American Review of Respiratory Disease 87: 37–46, 1963

    PubMed  CAS  Google Scholar 

  • Snider Jr DE, Salinas L, Kelly GD. Tuberculosis: an increasing problem among minorities in the United States. Public Health Reports 104: 646–657, 1989

    PubMed  Google Scholar 

  • Snider GL. Pulmonary tuberculosis and centrilobular emphysema. The ‘upright theory’ of apical localization. Archives of Internal Medicine 111: 762–771, 1963

    Article  PubMed  CAS  Google Scholar 

  • Soejima R, Mikata A. Recent extrapulmonary tuberculosis (in Japanese). Kekkaku 60: 83–104, 1985

    Google Scholar 

  • Stead WW. Undetected tuberculosis in prison: source of infection for community at large. Journal of the American Medical Association 240: 2544–2577, 1978

    Article  PubMed  CAS  Google Scholar 

  • Stead WW. Tuberculosis among elderly persons: an outbreak in a nursing home. Annals of Internal Medicine 94: 606–610, 1981

    PubMed  CAS  Google Scholar 

  • Stead WW, Kerby GR, Schuleter DP, Jordahl CW. The clinical spectrum of primary tuberculosis in adults: confusion with reinfection in the pathogenesis of chronic tuberculosis. Annals of Internal Medicine 68: 731–744, 1968

    PubMed  CAS  Google Scholar 

  • Stead WW, Lofgren JP, Warren E, Thomas C. Tuberculosis as an endemic and nosocomial infection among the elderly in nursing homes. New England Journal of Medicine 312: 1483–1487, 1985

    Article  PubMed  CAS  Google Scholar 

  • Stead WW, To T. The significance of the tuberculin skin test in elderly persons. Annals of Internal Medicine 107: 837–842, 1987

    PubMed  CAS  Google Scholar 

  • Steiger Z, Nickel WO, Shannon GJ, Nedwicki EG, Higgins RF. Pulmonary tuberculosis after gastric resection. American Journal of Surgery 131: 668–671, 1976

    Article  PubMed  CAS  Google Scholar 

  • Subcommittee of the Joint Tuberculosis Committee. Chemotherapy and management of tuberculosis in the United Kingdom: recommendations of the Joint Tuberculosis Committee of the British Thoracic Society. Thorax 45: 403–408, 1990

    Article  Google Scholar 

  • Sunahara S. Problems of hydrazine metabolism (in Japanese). Nippon Ishikai Zasshi 46: 322–333, 1961

    Google Scholar 

  • Sunderam G, McDonald RJ, Maniatis T, Oleske J, Kapila R, et al. Tuberculosis as a manifestation of the acquired immunodeficiency syndrome (AIDS). Journal of the American Medical Association 256: 362–366, 1986

    Article  PubMed  CAS  Google Scholar 

  • Tuberculosis Clinical Conferences. Medical Journal of Australia 2: 176, 1977

    Google Scholar 

  • Umeki S. Rifampicin and pulmonary fibrosis. Archives of Internal Medicine 148: 1663–1667, 1988

    Article  PubMed  CAS  Google Scholar 

  • Umeki S. Comparison of younger and elderly patients with pulmonary tuberculosis. Respiration 55: 75–83, 1989a

    Article  PubMed  CAS  Google Scholar 

  • Umeki S. Adverse effects of antitubercular drugs and significance of measurement of the drug-stimulating lymphocyte transformation rate. Japanese Journal of Medicine 28: 335–340, 1989b

    Article  PubMed  CAS  Google Scholar 

  • Umeki S. Sequelae of pulmonary tuberculosis (in Japanese). Nippon Iji Shinpo 3445: 27–34, 1990

    Google Scholar 

  • Umeki S, Hashiguchi K, Sumi M, Okimoto N, Yagi S, et al. Age-associated changes in clinical features of pulmonary tuberculosis (in Japanese). Abstract. 66th Annual Congress of the Japanese Society of Tuberculosis, Kyoto, April 23, 1991. Kekkaku 66: 270, 1991

    Google Scholar 

  • Umeki S, Okimoto N, Soejima R, Hara Y. Investigation of severe tuberculous pneumonia associated with irreversible exacerbation after intensive antitubercular chemotherapy — with regard to the etiology of initial reversible roentgenographic progression. Kekkaku 64: 85–93, 1989

    PubMed  CAS  Google Scholar 

  • Umeki S, Shiojiri H, Nozawa Y. Chronic ethanol administration decreases fatty acyl-CoA desaturase activities in rat liver microsomes. FEBS Letters 169: 274–278, 1984

    Article  PubMed  CAS  Google Scholar 

  • Umeki S, Sumi M, Niki Y, Soejima R. Concentrations of Superoxide dismutase and Superoxide anion in blood of patients with respiratory infections and compromised immune systems. Clinical Chemistry 33: 2230–2233, 1987

    PubMed  CAS  Google Scholar 

  • Van Scoy RE. Antituberculosis agents isoniazid, rifampicin, streptomycin, ethambutol. Mayo Clinic Proceedings 52: 694–700, 1977

    PubMed  Google Scholar 

  • Weaver RA. Unusual radiographic presentation of pulmonary tuberculosis in diabetic patients. American Review of Respiratory Disease 109: 162–165, 1974

    PubMed  CAS  Google Scholar 

  • Weinstein L. Chemotherapy of microbial diseases. In Goodman and Gilman (Eds) The pharmacological basis of therapeutics, 5th ed, pp. 1090–1224, Macmillan Co., 1975

    Google Scholar 

  • Weller PF, Goetzl EJ. The human eosinophil. Roles in host defense and tissue injury. American Journal of Pathology 100: 793–820, 1980

    Google Scholar 

  • Yoshikawa TT, Nagami PH. Adverse drug reactions in tuberculosis therapy: risks and recommendations. Geriatrics 37: 61–68, 1982

    PubMed  CAS  Google Scholar 

  • Zierski M, Bek E. Side-effects of drug regimens used in shortcourse chemotherapy for pulmonary tuberculosis: a controlled clinical study. Tubercle 61: 41–49, 1980

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Umeki, S. Age-Related Changes in the Manifestations of Tuberculosis. Drugs & Aging 1, 440–457 (1991). https://doi.org/10.2165/00002512-199101060-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-199101060-00004

Keywords

Navigation