Abstract: Objective To investigate the clinical characteristics of elderly pulmonary tuberculosis (PTB), and to improve the level of diagnosis and treatment of elderly PTB.  Methods The clinical manifestations, imaging features, sputum examination results, PPD test results, complications, adverse reaction of anti-tuberculosis drugs and treatment effects of 160 elderly cases of PTB, who registered in Antituberculosis Institute of Shantou from January 2012 to December 2012, were analyzed retrospectively. SPSS 19.0 software was used for statistics. The detection rates of different ages were compared by Fisher exact probability test, comparison of complications in different groups was conducted by the composition of A and non A. P<0.05 was considered statistically significant and P<0.01 was considered significant difference. Results Elderly PTB cases accounted for 19.3% (160/828) of cases registered in the corresponding period. Cough (142/160, 88.8%) and expectoration (125/160, 78.1%) were the main symptoms, followed by loss of appetite (82/160, 51.3%). Cases with fatigue accounted for 47.5%(76/160), with weight loss accounted for 40.6% (65/160), with shortness of breath accounted for 39.4% (63/160), with hemoptysis sputum, fever, night sweat accounted for 18.1% (29/160), 16.2% (26/160) and 9.4% (15/160) respectively. Pulmonary infiltration, necrosis and proliferative lesions co-exist, most of the lesions was multiple lung area lesion (127/160, 79.4%) and cavitary lesions were common (66/160, 41.3%). The strong positive rate of PPD test was 29.5% (31/105), and that of 60- years-old group and above (34.7%, 26/105) was significantly higher than that of 70 to 84 age group (16.7%, 5/55) (Fisher’s exact test, P=0.011). Sputum acid fast bacilli (smear and/or culture） positive rate was high (121/160, 75.6%). Cases in positive bacteria group with cough accounted for 93.4% (113/121), while those in negative group accounted for 74.4% (29/39). Cases with expectoration in positive bacteria group accounted for 86.8% (105/121), while in negative group accounted for 51.3% (20/39). Cases with cough and expectoration in positive bacteria group were significantly higher than those in negative group (χ²=8.876, P<0.01;χ²=21.743, P<0.01). The complication was common (137/160, 85.6%), most of which was the lung infection (77/160, 48.1%). Other complications were diabetes mellitus (33/160, 20.6%), hypertension (28/160, 17.5%), chronic bronchitis (25/160, 15.6%) and emphysema (22/160, 13.8%). Drug-induced liver dysfunction wasthe most adverse reaction (36/160, 22.5%). The cure rate was 91.3% (146/160), among which the cure rate of new cases was 92.4% (134/145),and that of retreatment patients was 80.0% (12/15).During the treatment some patients had bad psychological health status due to economic difficulties (25/160, 15.6%). Conclusion The symptoms of elderly pulmonary tuberculosis are not typical, most of which are cough and expectoration. The chest lesions are wide and the cavitary lesions are common, sputum acid fast bacilli (smear and/or culture) positive rate is high, most of elderly pulmonary tuberculosis cases complicate with pulmonary infection, diabetes and other medical conditions. During the treatment some patients have bad psychological health status.

Key words: Tuberculosis, pulmonary/diagnosis, Tuberculosis, pulmonary/drug therapy, Aged