STUDY ON CLINICAL AND RADIOLOGICAL PRESENTATION OF PULMONARY TUBERCULOSIS IN DIABETIC PATIENTS IN A TERTIARY CARE HOSPITAL

Abstract

C. Babu Anand1, A. Vinoth2

BACKGROUND
Diabetes mellitus has been reported to modify the presenting features of pulmonary tuberculosis. In recent decades, with the increasing prevalence of tuberculosis in diabetes mellitus cases in the world, the relationship is re-emerging as a significant public health problem. Improved understanding of the bidirectional relationship of the two diseases is necessary for proper planning and collaboration to reduce the dual burden of diabetes and TB.
MATERIALS AND METHODS
The study was conducted at Thanjavur Medical College Hospital during the time period January 2017 to August 2017. It is a prospective study. 60 cases of diabetes mellitus with pulmonary tuberculosis were studied. Their clinical profile and chest radiograph results were analysed.
RESULTS
The predominant clinical symptoms noted were anorexia (82%), cough (80%) and fever (60%). 56% of male patients were smokers. Average duration of diabetes was 68 years. The average fasting and postprandial blood sugar values in the study group was 238.5 and 340.0 mg/dL, respectively. 100% of the patients were sputum positive for AFB. Out of these, 45% of cases were high sputum positivity (3+). Cavitatory lesions (52%) were the most common type of lesion noted in both age group patients followed by fibrosis (33%) and infiltration (25%). Lower lung field involvement was noted in 32% of patients and was more common in patients greater than 40 years.
CONCLUSION
Severe hyperglycaemia appears to be a contributory factor to the development of pulmonary tuberculosis in diabetics. This has potentially serious implications for tuberculosis control and it must become a priority to initiate focused and coordinated action like case finding, treatment of latent tuberculosis and efforts to diagnose, detect and treat DM may have a beneficial impact on TB control.

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