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Clinical and radiological study of pulmonary tuberculosis in diabetes mellitus

Author: 
Nilofer Shaik, Surendra Kumar, C., Satyasri, S., Harita Krishna Veerapaneni, Sajit Kishan Gollapalli and Raghu Ram Uppalapati
Subject Area: 
Health Sciences
Abstract: 

Back ground: Diabetes mellitus has been reported to modify the presenting features of pulmonary tuberculosis, but there are varying data, particularly regarding the association with lower lung field involvement. Objectives: Clinical and radiological study of pulmonary tuberculosis in diabetic patients. Methods: 70 cases of diabetes mellitus with pulmonary tuberculosis were studied. Their clinical profile, relevant tests and chest radiograph results were analysed. Results: The predominant clinical symptoms noted were anorexia (77.14%), cough (74.29%), and fever (64.29%). 81.63% of male patients were smokers. Clubbing was noted in 14.29% of our patients. Average duration of diabetes was 6.59 years. 74.29% of patients were anaemic and 60% of patients had an erythrocyte sedimentation rate above 50mm hr-1. The average FBS value was 227 mg/dl. 72.73% of patients were sputum positive for acid fast bacilli under the age of ≤50 years. Cavitary lesions were noted in about 52.88% of patients. 27.14% of patients had infiltration. Fibrosis was noted in 30% of patients. Lower lung field involvement was noted in 25.71% of patients and was more common in patients greater than 50 years. Conclusion: Multiple cavities and multiple lobe involvement are more common in tuberculous diabetics and lower lung field is involved more commonly in older age group patients. Severe hyperglycaemia appears to be a contributory factor to the development of pulmonary tuberculosis in diabetics. Diabetes appears to have no effect on the presenting features of pulmonary tuberculosis to a large extent.

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