18 year old male complaining high grade fever with pain chest since 2-3 months associated with cough.. Appetite is reduced and pt become generalized weak.. Also complaining diarrhoea infrequently.. He was working as a water supplier house to house.. No family history of as such relevant disease.. . He hv quit smoking.. Tlc count is 8800..pls give ur valuable opinion regarding diagnosis and treatment... Thank u

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Scan shows well defined lesion of infiltrates rt middle lobe as well as old fibrovascular cavity lt mid zone with fres infections. Theses findings with long standing h/o cough and fever suggests pul tb. The only point is you said high grade fever for 2to3 months which is unlikely as pt must be dehydrated toxic and serious so monitor the temp and other investigations like cbc esr widal and dengue profile and so also cbnaat hrct etc. And than specific treatment till than iv fluids with broadspectrum antibiotics.

left sided secondary spontaneous pneumothorax with bilateral lung infilterates s/o pulmonary tb

Can it be a case of legionnaires disease???
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Encysted pneumothorax left. Infiltrations with cavities left upper lung and right midzone.

Infiltration and breakdown RMZ, LUZ, LMZ, Cavitery lesion LMZ with Pneumothorax Left.

It's a case of pneumothorax.

First Icd Everything else later I think you are suspecting legionnaires because he is a water supplier Without specific rx such patient will be toxic and worsen fast so i dont think so Still a possibility

Left side pnemothorax with pulmonary tuberculosis.. Adv ictd and start anti tb after sputum examination..

Can it be a case of legionnaires??
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Most common cause is pneumoconiosis/ Tuberculosis: Immunological status, Blood sugars, sputum AFB, culture & sensitivity: Lt sided chest tube insertion and pleurodosis, if necessary. Start ATT and address comorbodities.

Rt mid zone infiltration on leftlungwith cavity, pneumothorax a nd infiltration.

Left side pneumothorox: extensive fibrosis preventing complete collapse,Lt UZ, Mz fibrocavitary lesion. Rt UZ, MZ extensive fibrosis.

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