Concluded Case

21 yr old boy , k/c of Down's syndrome, presented with cough and fever of 2 days duration, not very co-operative but able to follow commands , speech impaired, cough ++, Temp 38c,Spo2 86%,BP 110/70,no edema on legs, clubbing+,JVP could not check and ECG also could not do,on auscultation air entry diminished on rt side wheeze present on Lt side ,tachycardia + no murmurs detected?

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Concluded answer

)There is cardiomegaly in x ray,probably some congenital heart disease associated with down's predisposing the patient to recurrent lung infection.both lungs are luking hyperinflated (rt>lt)devoid of bronchovascular markings probably pneumothorax with rt lower lobe consolidation and lt mid lower zone infiltration.2 d echo,cbc,sputum gram stain n culture,sputum for afb. O2 inhalation should be given n nebulisation started with antibiotics having pseudomonas coverage shuld be given on empirical basis and changed according to sputum report if patient does not responds.

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rt.lower zone pneumonitis ? Aspiration . With ? Khyphosis. Pls do 2-d echo to r/0 cardiac congenital anomaly . Sputum for gram and zn stain with cbc , esr , rbs , test for H1N1 should do. And childhood vaccination satus should cheque.

R basal pneumonitis. Both lungs overinflated. Heart condition should be ascertained (repeat trial ECG Echo) sputum exam for smear and AFB Sputum culture Sensitivity. Antibiotic Mucolytic andSupportive measures

Rt middle and lower lobe consolidation,LT middle zone infiltration,pulmonary hypertension,adv sputum c&s,counts and echo to rule out cardiac anomaly

)There is cardiomegaly in x ray,probably some congenital heart disease associated with down's predisposing the patient to recurrent lung infection.both lungs are luking hyperinflated (rt>lt)devoid of bronchovascular markings probably pneumothorax with rt lower lobe consolidation and lt mid lower zone infiltration.2 d echo,cbc,sputum gram stain n culture,sputum for afb. O2 inhalation should be given n nebulisation started with antibiotics having pseudomonas coverage shuld be given on empirical basis and changed according to sputum report if patient does not responds.

Pneumonitis rt. Lower lung field. Rx Amoxy clev 625 bd x 5 days Antipyretics Expectorant cough syrup Cbc.

Rt lower zone pneumonitis ??

Collapse of right middle and lower lobe with compensatory emphysema of right upper lobe. Pulm. Venous hypertension

hazziness in rt lower lobe Emphysematus rt lung

Hazy Right midde and lower lobe.left hilar opacity prominent..cardiomegaly.Advised sputum for AFB.CBC.ECG.Echo to rule out any cardiac anomaly.more chance of pulmonary tuberculosis with cardiac anomaly.Initiate treatment accordingly

Rt lowe zone consolidation with RVH to r/o vSD , also to r/o sec inf endocarditis

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