k/c/o sputum positive TB presented with breathlessness. C X R findings ?

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ryt upper lobe fibro cavitary lesion wit ryt hydropneumothorax wit underlying collapsed lung mediastinum shift to opposite side..requires icd insertion wit underwater seal..since patient is known case of sputum positive tb nd developed hydropneumothrx check for compliance of akt..send sputum gene xpert ..till thn continue akt..
correct diagnosis...
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pl start propylthiouracil or methylthiouracil propranolol . and investigation of hyprthd like usg thyroid radio iodine thyroid scan and tsh receptor antibody
seems to be Hydropneumothorax Rt, but CT thorax should be done before lCD to rule out infected cavity or bulla.
large rt hydropneumothorax along with post tb sequalae like extensive rt sided fibrosis and may be scoliosis
rt hydropneumo thorax with infiltrates left go for icd placement sputum afb and pleural fluid analysis
right side hydropneumo thorax
rt sided hydro pneumothorax
Rt hydro pneumothorax
right pneumothorax
Right Hydropneumothorax with underlying right lung collapse with right apical fibrosis And Scoliosis. Mediastinum appears relatively undisplaced (Central Trachea). Management:- 1)Needs ICD insertion with underwater seal 2) Propped up Position/O2 inhalation 3)Pleural fluid analysis (Microscopy/Biochemistry/ADA/Gene Expert/cytology) 4) Evaluate for MDR TB if he is resistant to standard 4 drug AKT. 5) Reapeat X ray chest to know about ICD position and Right lung expansion. 6) Determine his HIV status.
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