[The clinical picture of pulmonary tuberculosis over the past 40 years]

Most patients with pulmonary tuberculosis present to their physician because of the symptoms of this disease. This study was aimed at finding out how the clinical picture of pulmonary tuberculosis diagnosed for the first time changes in the patients hospitalized at our department in the years 1948-1986. Furthermore, the percentage of asymptomatic patients, the frequency of detectable cavern and mycobacteria tuberculosis were established. During the time period studied a change in clinical picture of the disease occurred as seen on the 13 symptoms followed. The previously common haemoptysis is a rarer symptom of tuberculosis at present (17.5% in the 1948-1950 population compared to 5.0% in the 1983-1986 population). There is an increasing number of patients in which tuberculosis manifests itself by breathlessness (2.3% of the 1948-1950 population compared to 10.9% in the years 1979-1981). In the whole period studied patients with symptoms prevail, the difference between the 1948-1950 period (71.1%) and that of 1979-1986 (67.0%) is not statistically significant. The number of patients with cavernous tuberculosis is decreasing (75% of patients in the years 1948-1950, 37% of patients in the years 1983-1986), there is an increase in bacteriologically proven diseases (33.9% of the 1948-1950 population, 73.0% of that of 1983-1986). The change in the clinical picture of tuberculosis is connected with the improvement of social conditions of the whole population, introduction of compulsory BCG vaccination and effective therapy, as well as bovine tuberculosis elimination. The change in the clinical picture of the disease is also influenced by the ever increasing mean age of the patients.