Patients with diabetes need to vigilant and “not typical” Tuberculosis
Posted on January 22, 2010
Filed Under Other complications | Leave a Comment
In recent years, diabetic patients with coronary heart disease or a clinical pulmonary tuberculosis is more common. However, concomitant coronary heart disease and tuberculosis are rare. And because of diabetic neuropathy, so that coronary heart disease, clinical manifestations of tuberculosis are not typical, it is worth attention of clinicians.
Typical Case
Patients with old Yan, 74-year-old, recently had no incentive to cough, cough even white sticky sputum, no chills, fever, stuffy nose, runny nose, no hemoptysis, night sweats and other symptoms. Self-serve some cold medicine, but no improvement in cough. Since the onset, non-progressive weight loss. Vital signs were stable. Coarse breath sounds lungs, both lungs at the end of audible sound and fine wet, heart rate ranged from 180 to 200 times. Denied coronary heart disease, high blood pressure, history of chronic diseases.
After admission chest X-ray film prompted a large dense shadow right lower lung, lung markings thickening. ECG examinations showed rapid atrial fibrillation. With a history of initial diagnosis: 1. Bronchial infection. 2. Secondary pulmonary tuberculosis? 3. Rapid atrial fibrillation (coronary heart disease?). The next day the test results in accordance with the diagnosis of type 2 diabetes was established.
Take into account not just for the lung lesions in patients with infections, tuberculosis should be excluded. But the patient was dry cough, sputum can not be OK. Cha tuberculin test was negative tuberculin test (PPD) negative. The last line of the chest CT examination was prompted to the left lung and a small amount of secondary-type tuberculosis pleural effusion.
Doctors Comments
Survey shows that diabetes is complicated by the risk of cardiovascular disease in non-diabetic patients with 2 to 4 times. This course in patients with no “chest pain, chest tightness, palpitations” and so clinical symptoms of coronary heart disease. Was mainly due to diabetes, longer duration, causing cardiac autonomic neuropathy, causing pain caused by lack of myocardial ischemia, when myocardial ischemia or heart rate is often no obvious sense, there painless angina, masked the symptoms of coronary heart disease.
Diabetes, and tuberculosis patients and higher than normal risk of 4 ~ 8 times. More men than women, the incidence rate increased with age, showed an upward trend. Two diseases affecting each other, diabetes, tuberculosis treatment for the adverse effects of a relatively significant, must be based on the control of diabetes and tuberculosis treatment can be effective. Chemotherapy of pulmonary tuberculosis and diabetes programs should be appropriately extended. The patients with atypical symptoms of tuberculosis, no low-grade fever, night sweats, chest pain, hemoptysis, weight loss and other symptoms of poisoning, tuberculosis, combined with a dry cough without sputum, sputum can not be OK. PPD test is negative, to bring some difficulties in diagnosis. Last on chest CT, clinical experience and efficacy of the final diagnosis of tuberculosis diagnosis.
Diabetes excellent thermal paper recommended 16 shall eat fruits and vegetables for two months on the hypoglycemic control the diabetes, the postprandial hypoglycemic faithful sugar water, sugar, Friends of the hypoglycemic Tips wolfberry 6 new tips to lower blood sugar and vegetables Qi diabetes how to eat breakfast Analysis of the relationship between diabetes and high blood pressure diabetes + diet
More diabetes-date information, please pay attention to diabetes, Channel 39 – China’s first Diabetes Portal
Comments
Leave a Reply