Clinical, imaging and bronchoscopy findings of 57 cases of diabetes mellitus complicated with tracheobronchial tuberculosis

doi:10.19871/j.cnki.xfcrbzz.2023.01.005

Abstract

Abstract: Objective To explore the clinical, imaging and electronic bronchoscopy manifestations of diabetes mellitus complicated with tracheobronchial tuberculosis, so as to provide clues for the early diagnosis of diabetic TBTB. Method From January 2020 to December 2021, 824 patients with diabetes and first-treat pulmonary tuberculosis were hospitalized in Nanjing Second Hospital, among which 57 were diagnosed with TBTB after electronic bronchoscopy. Demographic characteristics, clinical symptoms, glycosylated hemoglobin, chest CT scan, TBTB pathological typing and etiological examination results were analyzed. Result Among the patients with diabetes and first-treated pulmonary tuberculosis hospitalized during the same period, the detection rate of TBTB was 6.92% (57/824). The average age of the 57 diabetic patients with TBTB was (57.5±14.6) years old, more men than women (2.8:1), and the age of onset in men was lower than that of women [(54.9±14.5)years vs (64.7±12.3)years], and there was a statistically significant difference in age between genders(P<0.05). Cough (46 cases, 80.7%) was the main symptom of diabetic patients with TBTB, and the average glycated hemoglobin level was (9.18±2.03)%. All patients showed direct or indirect signs of TBTB in chest CT images. The direct signs were mainly wall thickening (18 cases, 31.6%) and lumen stenosis (20 cases, 35.1%), and the indirect signs were mainly multiple nodular shadows (40 cases, 70.2%) and cavity shadows (27 cases, 47.4%).The main lesions of diabetes mellitus complicated with TBTB were the left upper bronchus (22 cases, 38.6%), right upper bronchus (23 cases, 40.4%) and right lower bronchus (18 cases, 31.6%), and 28 cases had ≥2 lobe segmental bronchial invasion sites, accounted for 49.1%. The pathological type was mainly type Ⅳ (40 cases, 70.2%) and mixed type (38 cases, 66.7%). Sputum tuberculosis was positive in 26 cases, lavage fluid tuberculosis was positive in 45 cases. The positive rate of lavage fluid was significantly higher than that of sputum (78.9%: 45.6%). Conclusion For diabetic patients with poor blood glucose control, repeated cough and direct or indirect signs of TBTB on chest CT, bronchoscopy should be performed early, and the diagnosis should be confirmed by combined etiological and pathological examination.

Key words: Diabetes, Tracheobronchial tuberculosis, Electronic bronchoscopy

CLC Number:

R58
R523

Wu Zhisong, Ma Nanlan, Zeng Yi, Zhang Cheng, Wang Wenlian. Clinical, imaging and bronchoscopy findings of 57 cases of diabetes mellitus complicated with tracheobronchial tuberculosis[J]. Electronic Journal of Emerging Infectious Diseases, 2023, 8(1): 26-30.

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