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Revista Medica Herediana

Print version ISSN 1018-130XOn-line version ISSN 1729-214X


DELGADO ROSPIGLIOSI, Juan Luis; SECLEN SANTISTEBAN, Segundo Nicolás  and  GOTUZZO HERENCIA, Eduardo. Tuberculosis in diabetic patients: An epidemiologic and clinical study at the Hospital Nacional Cayetano Heredia. . Rev Med Hered [online]. 2006, vol.17, n.3, pp.132-140. ISSN 1018-130X.

Objectives: To describe epidemiological and clinical characteristics of diabetic patients with tuberculosis at the Hospital Nacional Cayetano Heredia (HNCH). Material and methods: Retrospective, observational, descriptive study. Diabetes Mellitus (DM) patients with Tuberculosis (TB) were found by searching the register books of the Endocrinology Service, Medicine in-patients Unit and Infectious and Tropical Diseases Department at the HNCH between 1997-2003. Results: There were 85 episodes on TB in 74 analyzed charts. The mean age was 49.4 + 12.8 years; 65% males, 35% females. 72/74 (97.3%) patients had type 2 DM. Patients were diagnosed with DM a mean of 4.2 +4 years prior to development of TB. 75/85 (88.2%) cases presented with pulmonary TB, of whom 51.3% were diagnosed by positive sputum smear. 59/85 (69%) cases were not regularly compliant with the treatment for DM and 60/85 (71%) had poor metabolic control when they developed TB. 31/74 (42%) patients were hospitalized because of TB. 51.4% of the hospitalizations were associated with diabetic ketoacidosis (DKA). TB can be a leading cause of DKA in our patients. The rate of treatment failures was 15/85 (17.6%); there was suspicion of MDR-TB in 13/74 (17.6%) patients. The rate of relapses was 15/74 (20.3%). 3/74 (4%) patients died during the period of study. Conclusions: Diabetic patients with poor metabolic control and TB frequently develop relapses, treatment failures and MDR-TB, raising significant concerns about nosocomial transmission. (Rev Med Hered 2006;17:132-140)

Keywords : Tuberculosis; diabetes mellitus.

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