25yr / M, Hair stylist by profession, non smoker, non DM, non HTN presented with cough and SOB with chronic ill health for last three months, his CBC, TIGE, Spirometry and CXR attached.

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Fibronodular lesions bilateral . Rt side is more than lt . Tige is quite high with increased esr pft is pict of obstructive respiratory disease.being hair dresser more likely to be old c/o allergic bronchitis with secondary pultb.

Thanx dr Salim Merchant
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This pt is suffering from chronic disease as is evident from his history.... Serum IgE is elevated....Now allergic component is there with presence of bilateral upper lobe infiltrates... Trachea is slightly shifted to right in normal subjects and so is here.... PTB should be ruled out but also see other causes for the same....

Thanks to all the Experts for their valuable opinion. Yes, he is suffering from Pulmonary Tuberculosis and is Sputum AFB positive (2+). He is also having Airway hypersensitivity and Bronchospastic disorder. His Sputum for AFB report now enclosed.

Trachea shifted to right. Right hilum elevated. Fibrocavitary lesions right upper lung. PTB

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right upper zone infilterates; get sputum afb done

TRACHEA IS SHIFTED TO RT .RT HILUM IS.DRAWN UP FIBROTIC LESION BOTH APICES MORE ON RT ESR IS RAISED , SPTUM EXAM FOR AFB BLOOD SUGAR HIV ---AB ARE NECESSARY INVESTIGATION PT IS DYSPONEIC .BECAUSE...OF .LOSS OF LUNG VOLUME

This x ray shows haziness in rt.lung. this lesion looks like pulmonary tuberculosis. So sputum for a.f.b examination is to be done for 3 days. Pt.looks like he had lost wt.so go for Hiv testing also

Sir, Should we add HCV HBV.?
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Right upper zone infiltrates

Rt apical Koch's COPD emphysema allergic

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