65 m chronic smoker fever cough with expectorant decrease apetite wt loss sob lt chest pain tc 19000 ESR 110

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Non homogeneous opacity in the left hilar area.. Extending to mid and lower zone.. Suggestive consolidation.. Left hilum also prominent.. Treat intially as community acquired pneumonia.. With antibiotics and other supportive measures.. Will need cect thorax to exclude any primary abnormality in the left lung... Tuberculosis may also need exclusion by sending afb smear and bactec culture and gene Xpert plus..
rt sir we r going on that way sp afb negative no any organism on gram stain on ct report suggest mostly its chronic infective condition but could be a bronchogenic carcinoma require bronchoscopy

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Homogenous opacity In left mid zone with hilar prominence. Mediastinal shift to left with compensatory emphysema of right side. Suggests obstructive lesion. Probably bronchogenic ca. Common in smokers and common in central airways. Needs CECT chest and bronchoscopy.
Need CECT LUNG / AFB sputum examination with bronchoscopy - Left side Opacities can be ruled out after the following tests - as Dr.Poddar sir told treat it like CAP and based on reports will follow further treatment .
left hilar opacity with superior mediastinal widening, i guess peesentation is not acute here n pt is also having c/o wt loss so for this age CECT is definately recommended to r/o central mass n med LNpathy
Definitely mam we have done ct report says predominantly chronic infective condition could be bronchogenic carcinoma require bronchoscopy

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Send sputum for afb, gram stain and culture first possibility tb if sputum negative then cect thorax and bronchoscop
sputum for AFB....if it showz negatiiv 1ce...repeat it again...if it again come negativ....go thru malignancy...CTC
Pulmonary koch's left, advised AKT.
?middle zone consolidation
?lung cancer
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