Abir Hedhli1, Hajer Racil1, Sonia Habibech1, Saoussen Bacha1, Sana Cheikhrouhou1, Naouel Chaouch1 and Abdellatif Chabbou1
1Pulmonology, Abderrahmen Mami Hospital, Ariana, Tunisia
Introduction: The association of pulmonary tuberculosis and diabetes presents clinical, radiological and therapeutic particularities.
Objectives: To determine the clinical and radiological characteristic and outcomes of pulmonary tuberculosis (PT) in patients with diabetes mellitus.
Materials and Methods: we conducted a retrospective case-control study between 2007 and 2012 on 120 patients hospitalized in a pulmonology department for a first episode of confirmed PT. patients were divided into two groups: group 1 (G1) represents 30 diabetics and Group 2 (G2) included 90 non diabetic patients.
Results: The mean age was 45.5 years in G1 and was comparable to the G2. All patients were male. Diabetes was type 2 in 76% of cases. General symptoms were more frequent in the G2 (p=0.04). Dyspnea was more noted in the G1 (p=0.03). The classical various types of radiological lesions of PT were found in similar proportion in the two groups with parenchymal shadowing the most frequent appearance in both diabetics (86%) and control (84%). However cavitations occurred less frequently in diabetics than controls (p=0,04). Radiological abnormalities were bilateral and diffuse in 65% of cases of G1 against 45% in G2 (p=0.01). There was a trend for basal lesions to occur more frequently in diabetics than controls (p=0.005). The delay of sputum smear conversion was longer in G1(p=0.03). An extension of the duration of treatment was necessary in 22% of patients in the G2. Two patients died in the G1 within the first 24 hours of hospitalization.
Conclusion: Diabetics have severe forms of tuberculosis, atypical and often extensive radiographic abnormalities, requiring special care to prevent complications.
