If latent tuberculosis reactivates in older people, it may cause few symptoms. Thus, doctors may not suspect it for weeks or months. In older people, the presence of other disorders also makes it hard to diagnose reactivated tuberculosis.

Older people who live in a nursing home are at risk of being infected with tuberculosis. The pneumonia that results may not be recognized as tuberculosis. Thus, it may not be appropriately treated and may spread to other people.

In the United States, miliary tuberculosis most often affects older people. Miliary tuberculosis is a potentially life-threatening type of tuberculosis that occurs when a large number of the bacteria travel through the bloodstream and spread throughout the body.

Tuberculosis that infects the tissues covering the brain (called tuberculous meningitis) is also more common among older people. This life-threatening infection causes fever, constant headache, neck stiffness, nausea, confusion, and drowsiness that can lead to coma.

If older people have long-standing latent tuberculosis, doctors weigh the risk and benefits of using antituberculosis antibiotics to prevent active tuberculosis from developing. The risk that these drugs may have harmful effects may be greater than the risk of developing tuberculosis. In such cases, doctors often consult a tuberculosis expert before they decide whether to use antibiotics.