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IP Indian Journal of Immunology and Respiratory Medicine


Lower respiratory tract infection in diabetes mellitus


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Author Details: Rajesh P. Pimpaldara, Manisha Vasava, Rakesh Pimpaldara

Volume : 2

Issue : 3

Online ISSN : 2581-4222

Print ISSN : 2581-4214

Article First Page : 78

Article End Page : 81


Abstract

Introduction: Respiratory tract infections are perhaps the most common human illness. At present an epidemic of Diabetes mellitus (DM) is ongoing both in developed and developing countries. This study was conducted to analyze clinical impact of DM on lower respiratory tract infections (LRTI).
Materials and Method: Total of 50 cases of DM with lower respiratory tract infections were analysed in a period of 2 years during December 2013 to December 2015 to study the association between DM and lower respiratory tract infections. All 50 patients selected randomly from all ages and either sex admitted in TB and Chest ward of Pandit Dindayal Upadhyay Government Medical College and Hospital, Rajkot.
Results: The present study was carried out on 50 patients having DM with LRTI. The commonest age group affected was of 40-60 years (62%). Males were affected more than females with male: female ratio was 1.9:1. 72% patients were from rural area with 60% patients were from lower socioeconomic status and 36% patients were from middle socioeconomic status. Cough and fever were most common symptoms (96%). Besides that anorexia, weight loss, breathlessness, chest pain and haemoptysis were observed in 48%, 42%, 28%, 28% and 12% respectively. Duration of DM was less than 1 year and 1-5 years in 30% and 42% patients respectively. 10% patients had controlled DM while 70% had uncontrolled DM. 50% patients were on oral hypoglycaemic agents (OHA), 24% were on insulin and 6% were on both OHA and insulin, while 20% were first time detected as diabetic. Among all causative organisms of LRTI, Mycobacterium tuberculosis was the most common organism isolated in about 44% of patients. Other organisms like Streptococcus pneumonia (4%), Klebsiella pneumonia (4%), Staphylococcus aureus (2%), Pseudomonas aeruginosa (6%), Escherichia coli (2%), and Influenza A (H1N1) (6%) were also isolated. No organism was isolated in 32% patients. Radiologically, 48% patients had moderately advanced lesion, 40% had far advanced lesion and 12% had only minimal lesion. 40% patients had unilateral involvement while 60% had bilateral involvement. 80% patients had exudative lesion, 50% had cavitatory lesions while 16% had nodular lesions.
Conclusions: Study revealed that Lower respiratory tract infection is common clinical illness among diabetic patients. DM patients with age more than 50 years, duration more than 4 years and uncontrolled DM status have more chances of developing pulmonary infection and other DM related complication. Mycobacterium tuberculosis is the most common isolated pathogen among DM with LRTI patients. DM with pulmonary tuberculosis (TB) patients has higher sputum positive grading. Radiologically, moderate to far advanced lesions are more common with predominant exudative or mixed variety. There are higher chances of lower lobe involvement in DM patients. Influenza A (H1N1) pneumonia has higher mortality in diabetics than non-diabetics.

Keywords:
Cough; DM; Lower respiratory tract infections; TB

Doi No:-10.18231