20 year old pt chief complain lower abdomen pain and gastritis. 6 day before pt feel severe pain in chest and take medicine from medical shop not a doctor advise. pt feel pyrexia,breathless during walking , laziness. past history-6 month before pt having cough and mild chest pain and feel pyrexia and take Rx many unregistered doctor. pt are not economical sound. sir/mam suggest dx and Rx.

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Ultrasound guided aspiration of collection Send sample for Routine ,ADA and c/s Till cultures arrive you can start with pip+tazo with linezolid Decortication should be kept as next line of management if patient does not show signs of improvement

Clinically likely TB chest and abdomen. Work up to prove or disprove. Enroll her in nearest DOT centre once you get etiology. Build nutrition. Counseling and track other family members / contacts

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Tubercular pleurasy need US guided tapping for confirmation.

MAY BE TUBERCULAR PLEURISY . TAP & SEND THE FLUID FOR CONFIRMATION.

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Needed urgent usg guided pleural tapping n fluid send for examination to rule out Kochs or pneumonia.. As Effusion is located there may be chances of lung abscesis.... Don't early tapper higher antibiotics... Let's the report come....

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Tap fluid and send sample for tlc,dlc, sugar,protein, ADA, AFB stain

This could be tubercular pluresiy tap do pcr and strat ATT

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Needs some more history and clinical findings. I don't think tapping will be positive for Koch.

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Pleural tap must done to rule TB Symptomatic treatment with broad spectrum IV antibiotics

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Usg guided aspirations ??? Tubercular pleurisy

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