{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:33Z","timestamp":1784557053060,"version":"3.55.0"},"reference-count":8,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,7,29]]},"abstract":"Summary<\/jats:title>\n Diabetes mellitus was identified as a risk factor for developing tuberculosis (TB) infection, and relapse after therapy. The risk of acquiring TB is described as comparable to that of HIV population. The fact that diabetics are 3\u00d7 times more prone to develop pulmonary TB than nondiabetics cannot be overlooked. With DM recognized as global epidemic, and TB affecting one-third of the world population, physicians must remain vigilant. We present a 45-year-old woman born in Dominican Republic (DR), with 10-year history of T2DM treated with metformin, arrived to our Urgency Room complaining of dry cough for the past 3months. Interview unveiled unintentional 15lbs weight loss, night sweats, occasional unquantified fever, and general malaise but denied bloody sputum. She traveled to DR 2years before, with no known ill exposure. Physical examination showed a thin body habitus, otherwise well appearing woman with stable vital signs, presenting solely right middle lung field ronchi. LDH, ESR, hsCRP and Hg A1C were elevated. Imaging revealed a right middle lobe cavitation. Sputum for AFB disclosed active pulmonary TB. Our case portrays that the consideration of TB as differential diagnosis in diabetics should be exercised with the same strength, as it is undertaken during the evaluation of HIV patients with lung cavitation. Inability to recognize TB will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace.<\/jats:p>\n \n Learning points<\/jats:title>\n \n \n \n Diabetes mellitus should be considered an important risk factor for the reactivation of pulmonary tuberculosis.<\/jats:p>\n <\/jats:list-item>\n \n High clinical suspicious should be taken into consideration as radiological findings for pulmonary tuberculosis in patients with diabetes mellitus may be atypical, involving middle and lower lobes.<\/jats:p>\n <\/jats:list-item>\n \n Inability to recognize pulmonary tuberculosis will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1530\/edm-16-0035","type":"journal-article","created":{"date-parts":[[2016,7,29]],"date-time":"2016-07-29T11:24:07Z","timestamp":1469791447000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":13,"title":["Diabetes mellitus: an important risk factor for reactivation of tuberculosis"],"prefix":"10.1530","volume":"2016","author":[{"given":"Ernesto","family":"Sol\u00e1","sequence":"first","affiliation":[{"name":"1Endocrinology Department, San Juan City Hospital, San Juan, Puerto Rico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Rivera","sequence":"additional","affiliation":[{"name":"1Endocrinology Department, San Juan City Hospital, San Juan, Puerto Rico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Mangual","sequence":"additional","affiliation":[{"name":"1Endocrinology Department, San Juan City Hospital, San Juan, Puerto Rico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Martinez","sequence":"additional","affiliation":[{"name":"1Endocrinology Department, San Juan City Hospital, San Juan, Puerto Rico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin","family":"Rivera","sequence":"additional","affiliation":[{"name":"2Pulmonary Medicine Department, San Juan City Hospital, San Juan, Puerto Rico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Fernandez","sequence":"additional","affiliation":[{"name":"2Pulmonary Medicine Department, San Juan City Hospital, San Juan, Puerto Rico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"key20160816165656289_bib1","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.2337\/dc13-2939","article-title":"Prevalence of diabetes among Hispanics\/latinos from diverse backgrounds: The Hispanic Community Health Study\/Study of Latinos (HCHS\/SOL).","volume":"37","author":"Schneiderman","year":"2014","journal-title":"Diabetes Care"},{"key":"key20160816165656289_bib2","doi-asserted-by":"crossref","first-page":"e92623","DOI":"10.1371\/journal.pone.0092623","article-title":"Diabetes and risk of tuberculosis relapse: nationwide nested case-control study","volume":"9","author":"Lee","year":"2014","journal-title":"PLoS ONE"},{"key":"key20160816165656289_bib3","doi-asserted-by":"crossref","first-page":"574","DOI":"10.2105\/AJPH.87.4.574","article-title":"The role of diabetes mellitus in the higher prevalence of tuberculosis among Hispanics","volume":"87","author":"Pablos-M\u00e9ndez","year":"1997","journal-title":"American Journal of Public Health"},{"key":"key20160816165656289_bib4","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/S1473-3099(09)70282-8","article-title":"Tuberculosis and diabetes mellitus: convergence of two epidemics","volume":"9","author":"Dooley","year":"2009","journal-title":"Lancet Infectious Diseases"},{"key":"key20160816165656289_bib5","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1086\/590565","article-title":"Tuberculosis in poorly controlled type 2 diabetes: altered cytokine expression in peripheral white blood cells","volume":"47","author":"Restrepo","year":"2008","journal-title":"Clinical Infectious Diseases"},{"key":"key20160816165656289_bib6","doi-asserted-by":"crossref","first-page":"249","DOI":"10.4093\/dmj.2013.37.4.249","article-title":"Diabetes mellitus and tuberculosis","volume":"37","author":"Koo","year":"2013","journal-title":"Diabetes and Metabolism Journal"},{"key":"key20160816165656289_bib7","article-title":"United States Census Bureau","year":"2015"},{"key":"key20160816165656289_bib8","first-page":"7","article-title":"Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis","volume":"58","author":"Centers for Disease Control and Prevention (CDC)","year":"2009","journal-title":"Morbidity and Mortality Weekly Report"}],"container-title":["Endocrinology, Diabetes & Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2016\/1\/EDM16-0035.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2016\/1\/EDM16-0035.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:46:19Z","timestamp":1784555179000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,29]]},"references-count":8,"URL":"https:\/\/doi.org\/10.1530\/edm-16-0035","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,29]]}}}