In patients with diabetes and pulmonary lesions, concomitant or sequential fungal and tuberculous infections should be actively sought with stepwise microbiology (including bronchoalveolar lavage and tissue‑based methods) and early molecular testing (metagenomic next-generation sequencing/Xpert). Steroid exposure for organizing pneumonia may worsen or unmask tuberculosis and must be weighed against infectious risk. Multidisciplinary care (endocrinology-pulmonology-infectious diseases) and rigorous glucose control are essential.
Zheng et al. (2026) studied this question.