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78 cases with atypical clinical symptoms of senile pulmonary tuberculosis Analysis and Diagnosis

%: 390 cases of infectious tuberculosis patients,[link widoczny dla zalogowanych], cough accounted for 95-1%. Sputum after coughing, in second place. Survey showed that about 77.8% of active patients, 84.4% of infectious patients. M cough sputum or hemoptysis is one of the local symptoms. Activities were 29.4% and 39.2% of the infectious STD patients had bloody sputum or hemoptysis. In addition, some patients may also be chest pain,[link widoczny dla zalogowanych], shortness of breath or difficulty breathing and other symptoms. Systemic symptoms, including fever and others,[link widoczny dla zalogowanych], such as night sweats, fatigue, weakness, loss of appetite, weight loss, menstrual disorders of women, or Tuberculosis r} 1 bow l of allergic hypersensitivity in the conjunctiva from keratitis, skin erythema nodosum and so on. In the event there is 30.5% among sexually transmitted diseases, infectious in 36.2% ill patients is fever. Under normal circumstances, mostly low-grade fever (oral temperature of 37.4-38 ~ C); elderly tuberculosis patients, because of its physiological and pathological characteristics. So many patients do not have the typical clinical manifestations of tuberculosis, so often ignored. Delay in diagnosis, this paper summarizes our hospital in June 20o7 to June 2008 aged 78 cases of pulmonary tuberculosis patients with atypical clinical symptoms. As follows: 1 General information 57 cases of men, 21 women, aged 65 years of age a 98 years old, case collection conditions: age 65 years of age,[link widoczny dla zalogowanych], clinical diagnosis of tuberculosis,[link widoczny dla zalogowanych], but no typical clinical presentation of pulmonary tuberculosis: atypical tuberculosis 1.1 Clinical manifestations: General hospital were suspected of tuberculosis during the treatment was transferred to our hospital, and no one came to our hospital directly to tuberculosis treatment, diagnosis and treatment in general hospital 3-35 days, an average of l5 days; 1.3 diagnostic method, sputum Mycobacterium tuberculosis positive in 26 cases, 33.33%, fiber bronchoscopic biopsy confirmed 36 cases, accounting for 46.15%, ultrasound directed needle biopsy of l0 cases. Accounted for 14.10%, 6 cases of pathologically confirmed, accounting for 7.69%; 2.1 2.1.1 is difficult to diagnose because clinical manifestations are not typical. The lack of typical TB symptoms; 2.1.2 ignore conventional chest X-ray examination, or diagnosis of X-lack of experience is not typical of tuberculosis diagnosed as pneumonia, or even lung cancer error; 2.13 pairs diagnosed with questions or anti-inflammatory treatment in patients with poor TB sputum examination can not be done in a timely manner, or bronchial biopsy and lung biopsy, resulting in long-term patients can not get the correct diagnosis and treatment; 3 Discussion 3.1 senile tuberculosis. Is over the age of 65 years or older suffer from tuberculosis. Elderly due to decreased immunity and disease resistance. For children or adolescents can be infected and to stabilize the state of latent tuberculosis lesions down, down in old age when immunity to disease. Very small 3.2 TB symptoms typical of old age. May include fever, night sweats, weight loss and other symptoms, most without typical chest X-ray shadow, easily misdiagnosed as lung infection, lung cancer and other diseases, the sensitivity of tuberculin test is not high; 3I3 old unresponsive body and nervous system, description of symptoms and signs of self-clear, the symptoms of TB symptoms are sometimes masked by other diseases easily. Prone to the phenomenon of clinical misdiagnosis. Therefore, to be alert for the elderly, the clinical importance of atypical symptoms, symptoms of one of the following cases should be suspected of having tuberculosis may be atypical. (1) Long-term low heat; (2), night sweats, fatigue, lassitude, weight loss, and loss of appetite and other symptoms: (3) cough lasting more than 2 weeks; (4) or delayed healing of recurrent coughing up blood or sputum bloody towels; (6) position is more fixed. Persistent chest pain during deep breathing, coughing, increased by; 3.4 Early repeated smear is essential. Strong positive reaction to tuberculin test have TB disease may first consider, X line is the lateral film in conventional X ray film, based on the radiographs where appropriate, add photos, the first orientation film, on the infiltration of serum anti-TB antibody test off TB has some diagnostic value; 3.5 lung CT, bronchoscopy biopsy, ultrasound directed needle biopsy can be used as screening method for further diagnosis;
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