Treatment outcomes and clinical characteristics in diabetic versus non-diabetic sinonasal tuberculosis

Sinonasal tuberculosis (SNTB) is a rare extrapulmonary presentation with poorly understood interplay with diabetes mellitus (DM). Therefore, it is of interest to compare the clinical presentation, microbiological characteristics and treatment outcomes between 60 patients with DM with SNTB and 60 non-diabetic controls treated in one of the tertiary referral centers. DM patients had a longer duration of symptoms (18.4±6.2 vs 11.2±4.1 weeks, p=0.001), more complications (41.7% vs 18.3% p=0.004) and more disease on imaging (bony involvement: 55.0% vs 31.7, p=0.011). The culture positivity (78.3 vs 58.3, p=0.015) and drug resistance (multidrug- resistance: 15.0 vs 3.3, p=0.026) were more positive in microbiologically positive patients of DM. The results of treatment showed slower conversion of sputum in DM patients (8.3±2.1 vs 6.1±1.8 weeks, p<0.001), longer therapy period (9.8±1.2 vs 8.2±0.9 months, p<0.001) and reduced success rates (78.3% vs 91.7, p=0.032). Thus, outcome success was negatively related to glycemic control (r= -0.67, p=0.001).