[Pulmonary tuberculosis with diabetes mellitus, presenting multiple nodular shadows].

An asymptomatic 52-year-old male, who was diagnosed as poorly controlled diabetes mellitus (DM), was referred to our hospital because of abnormal shadows on chest X-rays. Physical examinations and laboratory data showed no abnormal findings except increased values of blood sugar and HbA1c (12.1%). Chest X-ray and CT scan revealed multiple nodular shadows in both lung fields. The specimens from transbronchial biopsy showed epithelioid granuloma, and Mycobacterium tuberculosis was confirmed with bronchial wash fluid. The patient was then treated with antimycobacterial drugs and sulfonylurea along with diet therapy. The multiple nodular shadows gradually disappeared. It seemed that impaired host defense mechanisms caused by poorly controlled DM is responsible for the bronchogenic dissemination of M. tuberculosis, resulting in the extension into the multiple nodular shadows. Thus, a good control of DM is important for the prevention of an onset and excerbation of tuberculosis in patients with DM.