24 M histry fever with hemoptysis ,vitals stable DD and treatment
Left lower lobe Infiltration and breakdown with areas of grownd glass opacification (? due to leaked blood). This is Pulmonary Tuberculosis. Get Sputum AFB and CBNAAT. FBS, CBC. Initiate with Antibiotics and switch to ATT when Reports are available.
Pulmonary tuberculosis. Get a sputum tested for AFB and geneXpert Also ESR , Montaux, LFT and CBC D/D - Bronchiectasis Pneumonitis
Sputum for afb should be and cbnaat also Pt. should be started with antifibrotic-inj piperacillin and tazobactam 4.5 iv tds,colchicine 0.6 mg bd,steroid-prednisolone 30-40 mg od,oxygen support,proton pump inhibitor,antiemetic if vomiting is there,neb with duollin tds,cough suppresants,analgesic if fever is there
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HRCT chest report is s/o B/l GGOs with b/l apical lobe infiltration.since pt is having hemoptysis,there may be superimposed infection with pul kochs. Tb reclav 625 mg TDS Tb moxiflox 400 mg OD Tb montair LC od Tb lorest 2 gm TDS Syp codistar 2 TSF TDS Tb pcm 650 mg sos Once hemoptysis settles send sputum for AFB CBNAAT DST.
PTB v/s pneumonitis Suptum for AFB Chest secretions for Gram stain and c/s CBC ESR Routine labs Can start with Tab.Augmentin 625mgs PO/BD till confirmation
Pt. X-ray report is suggestive of infection,send sputum for culture and sensitivity and also for T;B gram staining. How bad was haemoptysis, some times slight staying of sputum due To excessive coughing can be mistaken. if not sure take help of a chest specialist. Start abroad spectrum. Anti biotic don't go for steroids in case case turns out to be of TB. Again in India use steroid is very common for even trivial things.wait for report.
Ptb
Ptb
Pulmonary tuberculosis
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