Abstract

What methods would you choose apart from purified protein derivative (PPD) skin test and culture for acid-fasting bacilli (AFB) to make a clinical diagnosis of pulmonary tuberculosis (TB) in an aged patient with possible TB? These are two cases of pulmonary TB, that occurred with persistent low-grade fever, fatigue and anorexia due to a mild toxemia of tuberculosis. A final diagnosis of pulmonary tuberculosis was established on the basis of mild toxemia(low-grade fever), debilitation and characteristic pulmonary CT imaging, free of PPD and interferon-gamma release assay (T-spot). The authors realized that the dosage of anti-tuberculosis drugs should be carefully controlled and the improvement of their overall nutritional status to gain better efficacy is much more needed.

Keywords: Pulmonary tuberculosis (TB), The elderly, Mild toxemia, CT-imaging

References

[1] Seto, J., Wada, T., Suzuki, Y., et al., 2017. Mycobacterium tubereulosis transmission among elderly persons, yamagata prefecture, Japan, 2009-2015. Emerging Infectious Diseases. 23(3), 448-455.

[2] Eom, J.S., Kim, I., Kim, W.Y., et al., 2018. Household tuberculosis contact investigation in a tuberculosis-prevalent country: Are the tuberculin skin test and interferon-gamma release assay enough in elderly contacts. Medicine. 97(3), e9681