[Changing clinical pictures of tuberculosis in recent 25 years]

An analysis was made to find the chronological changes in clinical manifestation of tuberculosis, mainly through the retrospective review of clinical records and X-ray films of total 625 patients who were hospitalized in 1960, 1970 and 1984. It was found that there were no significant changes in radiological findings, proportion of pleurisy among respiratory tuberculosis and mode of detection during the past 25 years. Changes due to the aging of population and decrease in primary infection were; (1) increase of older patients over 50 years of age in pulmonary, pleural and miliary type tuberculosis, (2) increase of diabetes mellitus and other complications increased. Changes due to the advancement of chemotherapy were, (3) shortening in the duration of treatment, (4) decrease of patients with negative bacteriology among hospitalized cases, (5) shortening of duration of hospitalization, (6) marked decrease of patients undergone surgical operation, (7) decrease of relapsed patients, (8) increase of smear positive but culture negative patients, and (9) increase of open negative cases. Changes related to medical care were, (10) increase of delay in diagnosis and (11) increase of patients diagnosed first by post mortem examination. Above finding were discussed in relation to the analysis of the epidemiological trend of tuberculosis during this period.