Pulmonary cavitations in poorly controlled diabetic patients: is it tuberculosis? – case series of two patients
Abstract
Background: Poorly controlled type 2 diabetes mellitus (T2DM) increases the risk of severe respiratory infections and pulmonary complications, including lung abscesses and cavitary lesions. In tuberculosis-endemic regions, these findings are often initially attributed to tuberculosis, which may delay the diagnosis and management of other relevant infectious etiologies.
Case Presentation: We report a case series of two patients with poorly controlled T2DM who developed pulmonary cavitations in the right upper lung lobe following non-tuberculous infectious processes. The first case involved a 22-year-old woman with a recent dengue infection who developed a cavitary pneumonia without signs of sepsis and showed a favorable clinical course with conservative management using intravenous antibiotics. The second case was a 68-year-old man with T2DM and chronic obstructive pulmonary disease, initially treated for community-acquired pneumonia, who subsequently developed severe diabetic ketoacidosis, septic shock, and extensive pulmonary cavitation, requiring intensive care unit admission, broad-spectrum intravenous antibiotics, and surgical lobectomy.
Conclusion: Pulmonary cavitations in patients with poorly controlled T2DM represent a significant diagnostic and therapeutic challenge, particularly in tuberculosis-endemic settings. This case series underscores the importance of maintaining a high index of suspicion for non-tuberculous etiologies, achieving adequate metabolic control,…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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