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In England patients aged 65 years and over experience a delay of more than 4 months between onset of symptoms and diagnosis of pulmonary TB. This report examines three cases of patients experiencing significant delays in both diagnosis and treatment. Each case had a background of bronchiectasis. Symptoms were initially believed to be secondary to their pre-existing lung disease. Immunosenescence, atypical presentation and pre-existing lung disease mean there is often a significant delay in diagnosis in this population at both a primary care and specialist l