Abstract: Objective  We analyzed the clinical characteristics of elderly pulmonary tuberculosis (TB) in order to improve the diagnosis and treatment of this disease.  Methods  We retrospectively analyzed their clinical presentation, radiological features，sputum （or BALF） AFB，underlying diseases，anti-TB adverse effects and the responses to anti-TB chemotherapy among 643 hospitalized elderly cases with pulmonary tuberculosis in the 309th hospital.  Results  This group had 93.9% (604/643) secondary tuberculosis,6.1% (39/643) hematogenous dissemination,and no primary tuberculosis. The rate of the positive AFB including smear and culture from both sputum and BALF together was 31.9% (205/643). Coughing was the most common symptom (79.9%,514/643) which appeared more often in the positive AFB cases than that in the negatives（87.8% vs. 76.3%; χ²=11.614，P=0.001）. On the other hand, night-sweat appeared more common in the negatives (32.9% vs. 24.4%; χ²=4.774, P=0.029). Almost 90% of them had underlying diseases, 78.1% (450/576) had at least two kinds. The most common disease was pneumonia (51.2%,329/643) which was more popular in the positive AFB cases than in the negatives (57.1% vs. 48.4%; χ²=4.202, P=0.040).The hypertension was more common in females than in males (19.7% vs. 13.2%; χ²=4.380, P=0.036).Infiltration and necrosis were more common imaging in 604 case with secondary tuberculosis and multiple lung  fields were involved (41.4％，250/604). 59.5% (122/205) of them became sputum conversion negative after treatment during the hospitalization. The effective rate of this short-term chemotherapy was 87.1% (560/643), and the mortality rate was 5.1% (33/643). The most prevalent adverse effects of anti-TB chemotherapy were liver toxicity (6.4%,41/643).  Conclusion  The elderly pulmonary tuberculosis presented more with coughing, fever,some underlying diseases including the pneumonia as the top one.Their pulmonary focuses were characteristic with distributing in one more lung fields. Elderly pulmonary tuberculosis should be given personalized treatment.

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