Impact of diabetes on the presenting features of tuberculosis in hospitalized patients

Introduction: Diabetes mellitus (DM) is a risk factor for tuberculosis (TB) and may modify its presenting features. The aim of this study was to find out the influence of DM on clinical, radiological and treatment features of TB in hospitalized patients. Material and methods: In a retrospective study we reviewed the records of 123 patients with TB and DM admitted from 2000 to 2008 and compared this group with another one of 123 patients with TB without DM. Results: Although in both groups multilobar lung lesions predominated, there were more cases of isolated lower lung field (LLF) involvement in diabetics than in nondiabetics (10.6% vs 3.3%, p = 0.03). Cavitary lesions were less frequent (63.4% vs 82.1%, p = 0.01) and extra-pulmonary TB manifestations were more frequent (28.5% vs 16.3%, p = 0.02) in diabetics than in nondiabetics. There were no significant differences between groups regarding multidrug resistant - TB (MDR-TB) and adverse effects of anti-tuberculosis drugs. The in-hospital mortality was higher in diabetics (8.1% vs 0.8%, p = 0.01), but using a binary logistic regression there was significant difference in mortality only in respect to the variable MDR-TB. Conclusions: This study showed that DM affected some clinical and radiological presenting features in hospitalized TB patients. LLF involvement and extra-pulmonary TB manifestations were more frequent in diabetic patients than in nondiabetic ones. (C) 2011 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S. L. All rights reserved.