A study of clinical profile of community - acquired pneumonia in diabetes mellitus
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 20, Issue 2
Abstract
Background: Community- acquired pneumonia may cause significant morbidity and mortality, especially in patients who have comorbidities. Diabetes mellitus is associated with increased susceptibility to infection due to its deleterious effect on immunity and thus may affect pneumonia outcomes. Objective: To study the clinical, etiological, radiological profile and outcomes of community- acquired pneumonia in patients having diabetes mellitus. Methods: This was a cross-sectional observational study done in a tertiary care hospital over one year. We studied 115 adult patients who were hospitalized with a diagnosis of pneumonia and had pre-existing diabetes or who were first time detected to have diabetes. They were evaluated by clinical history, physical examination, chest X ray, blood investigations, sputum smear and culture. Blood sugars were done on admission and monitored frequently during hospital stay. Empirical antibiotic therapy was started till any definite microorganism with drug sensitivity patterns were identified, followed by specific therapy. Patient outcomes were recorded. Results: Out of 115 patients, 88 (76.5%) had type 2 diabetes and 27 (23.4%) had type 1 diabetes. Cough was the commonest symptom of pneumonia in both groups followed by dyspnea. Commonest chest radiographic pattern was multilobar lung involvement in type 1 DM and predominantly lower lobe involvement in type 2 DM. Mycobacterium tuberculosis was found to be the commonest organism causing pneumonia in 85% of type 1 DM cases, while S. pneumonia was commonest organism in type 2 DM patients (34%). There were 15 deaths in the study (13.04%). Mean HbA1c was high (11.9%) in the mortality group. Conclusions: Cough and dyspnea were predominant symptoms of pneumonia rather than fever. Pulmonary tuberculosis was the commonest cause of pneumonia in T1DM patients and TB should be borne in mind as a cause of pneumonia in diabetic patients. Uncontrolled hyperglycemia was associated with poorer outcomes as were impaired consciousness, leucocytosis and raised BUN.
Authors and Affiliations
Sameer Yadav, Pramod Darole, Tukaram Jamale, N D Moulick
Keywords
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