Clinico-radiological Presentation of Pulmonary Tuberculosis in Diabetes Mellitus

T2DM is recognized as a major risk factor for the progression of active Pulmonary Tuberculosis (PTB).Considering that both Diabetes mellitus and Tuberculosis are major public health problems,we carried out the present study to determine various clinical and radiological presentations of PTB in diabetes mellitus. This was an observational study.All patients with PTB and Diabetes mellitus, newly detected(PND) or known diabetes(PKD),after a detailed history and thorough examination, were subjected to sputum smear examination for AFB, FBS,PPBS, HbA1c and Chest X-rays. Out of 78 patients with Pulmonary Tuberculosis and Diabetes mellitus,46 (59.0%) patients were PND and 32 (41.0%) were PKD.There was male preponderance in both groups.28% of the PKD patients had diabetes for 1-2 years<strong>. In the PND group</strong> ,31(67.4%) patients were sputum smear positive ,15 (32.6%) were sputum smear negative.Forty six (100%) had cough with sputum and weight loss.Radiologically,36(78.3%) patients had lesions in lower lung field, 18 (39%) had minimal lesions , 33(71.7%) had right sided lesions,9 (19.6%) patients had multiple cavities and 31(67.4%) patients did not have cavities.<strong> In the PKD group,</strong>Majority (69.6%) of the patients had poor glycemic control with HbA1C&gt;8,23(72%) patients were sputum smear positive ,9(28%) patients were sputum smear negative,32(100%) patients had cough with sputum and weight loss.Radiologically,25(78%) patients had lesions in upper lung field and had right sided lesions.,12(37.5%) patients had multiple cavities and 16(50%) did not have cavities.Higher incidence of cavities was seen in the PKD group. Patients with PTB and Diabetes were mostly male in both groups. Cough ,sputum and weight loss were the most frequent symptoms in both PKD and PND.Fever was less common in both the groups.Both PND and PKD were more likely to be sputum positive(67.4% vs 72%) than sputum negative(32.6% vs 28%)..Radiologically,there was a higher involvement of upper lung field(78%) in PKD group as compared with PND group.and extent of lesion was almost similar in both the groups. Location of cavitary lesion over upper lung field(34.6% vs 6.4%) and multiple cavities(37.5% vs 19.6%) were more in PKD group as compared to PND group.