To Study a Specific Radiological Pattern of “Diabetic Tuberculosis” (as Described by Sosman and Steidl in 1923) Observed in Patients with Diabetes Mellitus Associated with Pulmonary Tuberculosis

Abstract

Background: Sosman and Steidl (1923) had described “diabetic tuberculosis” a specific radiological pattern in patients with diabetes mellitus associated with pulmonary tuberculosis. These lesions usually consist of wedge-shaped area of density in which there is often cavitation in the neighborhood of hilum and spreading toward periphery including the bases occurring in diabetics over the age of 40 years. The present study was undertaken to study and highlight this specific radiological pattern of “diabetic tuberculosis” along with the clinical profile of this association. Materials and Methods: The present study was carried out in patients with pulmonary tuberculosis admitted to Poona Chest Hospital Aundh Pune, between July 1, 1991, and June 30, 1992. The patients diagnosed as pulmonary tuberculosis were subjected for diabetic status by detailed history, clinical examination, and investigations. Results: Among 440 cases of pulmonary tuberculosis prevalence rate of diabetes mellitus was 9.55% (42/440) and a specific radiological pattern “diabetic tuberculosis” was observed in 16.66% (7/42) in diabetics associated with tuberculosis. Conclusion: All patients with pulmonary tuberculosis above the age of 40 years should be screened for diabetes and all patients with diabetes should be screened to rule out pulmonary tuberculosis every year. A specific radiological pattern of “diabetic tuberculosis” and lower zone lesions on X-ray observed during clinical examination should be screened to rule out pulmonary tuberculosis as well as diabetes.