Muhammed Niyas V. K1, Sajeeth Kumar K. G2
INTRODUCTION
Community-acquired pneumonia (CAP) Is a common and serious illness despite the availability of potent new anti-microbials and effective vaccines. For patients with community-acquired pneumonia, diabetes mellitus is one of the most common underlying diseases.
AIMS AND OBJECTIVES
1) To determine the aetiological agents of CAP in T2DM, 2) To determine what percentage of CAP diagnosed by British Thoracic society guidelines is actually due to M. Tuberculosis in T2DM, 3) To study the clinical profile of CAP in T2DM and 4) To determine the factors predicting mortality.
MATERIALS AND METHODS
1) Cases were selected as mentioned in inclusion criteria. 2) Informed consents were obtained. 3) All patients were evaluated by a detailed history, complete physical examination, CXR, CBC, RBS, RFT, LFT, Sputum and blood cultures and Sputum AFB. 4) Data was analyzed using SPSS v20.0 Tuberculosis cases were excluded when the clinical profile of CAP was studied.
RESULTS
A total of 89 cases were studied. 5 cases were found to have Tuberculosis as an etiology. Microorganisms could be isolated in 19% of the rest of the cases (84). Gram negative organisms were isolated more (56%) than gram positive organisms. Most common bacteria isolated was K. pneumoniae. The mortality was 16%. Out of the factors studied presence of coexisting CKD, COPD; breathlessness, tachycardia, tachypnea, hypotension and altered sensorium at presentation, impaired renal function and thrombocytopenia were significant predictors of mortality.
CONCLUSIONS
Tuberculosis is an important differential to be considered in CAP like presentation. The isolation of organisms by routine sputum and blood cultures is low. Of the organisms isolated Gram Negative organisms predominates in this area. Co-existing COPD, CKD, tachycardia, tachypnea, hypotension and altered sensorium at presentation, impaired renal function and thrombocytopenia are important predictors of mortality in patients of CAP with T2DM.
