A 15 yrs old boy complain coughing, fever,loss of appetite,weakness since 2 to 3 month.His weight is 38 kg. His blood report,Xray plate attached it.his Montoux test is positive.Plz see the all report and give valuable opinion.

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It seems to be a case of ptb with enteric fever. Start treatment for enteric fever meanwhile adv the pt. for SPUTUM AFB and CBNAAT. If the results confirm start ATT. In my opinion even if the results are negative give ATT for2mths as trial treatment and if there is considerable improvement complete the entire course of ATT.
Sir Att treatment dose

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ESR -80 Montaux test + Ve Fever , weight loss. Loss of appetite X-ray ray - infiltration left mid zone All features are in favour of Pulmonary tuberculosis
Infiltrations left mid zone. PTB.
Are you confirm sir , is it pulmonary tuberculosis?

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Suggestive of pulmonary TB Starts Akt
AFB for sputum -3 day
It's no more 3 days. Now it's for 2 days only.
10TU ppd not to be used...use 2 tu ppd only ... SPUTUM AFB Do CECT chest.. BAL sos if no sputum.. Look for lymphnodes For TB to diagnose microbiological confirmation required... Ask family history for TB do HIV testing... Only mantoux is not reliable to diagnose TB... do USG abdomen also... cxr show left hilar infiltrates Send blood culture.... Do above work up and then we can decide for akt
As per history maintained by you, and bloop investigation reports,ESR 80,& mantaux test positive,X ray chest shows infiltrations specially in left mz these all points are suggestive of PTB, go for sputum for AFB
Sputum for afb .start inj.ceftraxone for 5days .review with afb reports clinical improvement cbc
Send Sputum AFB , CBNAAT and start ATD whatever may b the sputum report and look for response.
Saccular beonchiectasis.Cavities with fluid levelled limited to a lung segment.
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