Pulmonary Tuberculosis in Patients with Diabetes Mellitus

Abstract

Abstract:Background: Diabetes Mellitus is associated with higher risk of lower respiratory tract infection including pulmonary tuberculosis with features which differ from that observed in the general non-diabetic population.Objective: To assess the effect of diabetes mellitus on the clinical, bacteriological and radiological presentation of pulmonary tuberculosis in diabetic population.Methods: This is a cross sectional study that enrolled 25 patients with diabetes mellitus and pulmonary tuberculosis. The patients included in this study had been randomly selected from those attending Al-Yarmouk Teaching Hospital in Baghdad-Iraq during the period between the 1st of June, 2003 to the 31st of May, 2004. All of the patients had been subjected to thorough physical examination and laboratory investigations. Results: This study revealed male to female ratio of 5:1. Sixteen percent of the sample (4 patients) was of type 2 diabetes mellitus. 56% of those with diabetes and pulmonary tuberculosis (14 patients) were diabetic for 0-10 years. 19 patients (76% of the sample) had sputum smear positive, the remaining 6 patients (24% of the sample) were smear negative/culture positive. Multiple lobe involvement was obvious in 64% of (16 patients). Lower lung field involvement had been detected in 32% of the sample (8 patients). Cavitary lesions had been diagnosed in 15 patients (60% of the sample). Conclusions: This study revealed that diabetes modifies the clinical and radiological picture of pulmonary tuberculosis. Diabetic patients are at higher risk of recurrence and extensive pulmonary involvement. Tuberculosis is associated with poor glycemic control. Diabetes changes the male: female ratio toward the side of male predominance. Lower lung field involvement is more common in diabetics who had pulmonary tuberculosis. Keywords: Pulmonary, tuberculosis, diabetes.