60 years male pt.. complaining of cough,fever since 5-7 days, hemoptysis 2 times today spo2 -94% not that much dypsnoec....give opinion about it whether it is Koch's or pneumonic consolidation,ESR-90

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There is bilateral hilar prominence more so on the right side.. There is non homogeneous dense area involving the major part of the right lung... Looks like consolidation.. But tuberculosis can not be ruled out entirety.. Treat as pneumonia.. Watch for the response.. If inadequate response.. explore for other diagnosis like tuberculosis by cect thorax...
Radiologically a case of right mid lower zone pneumonitis. Needs CBC sputum for AFB and GS.Response to antibiotics then att according to investigation.
rt mid lower pneumonitis withfibrotic changes with shifting of trachea to rt with volume loss... most likely chronic tb..
pneumonitis with pleural effusion adv sputum for AFB
Depends on onset and duration of illness, acute with high grade fever or chronic with low grade fever. Any immunocompromised condition like HIV or DM. initially antibiotic s sputum AFB after hemoptysis settles. strong suspicion of TB , ATT can be started without waiting sputum result because in hemoptysis sputum is falsely positive for AFB.
if any pleural fluid can be tapped, it can be send for analysis including ADA.
right sided pneumonitis with pleural effusion, do tapping of pleural fluid and get pleural fluid ADA report, that would confirm diagnosis of tuberculosis, till then treat the patient on I've antibiotics, proper fluid management, akt can be started after confirming diagnosis of tuberculosis
rule out t.b and possibility of a mass. get sputum analysis fr AFB, Nocardia, g stain, fungus and c/s done. get galactomannan done if fungal smear is positive. rule out possibility of a mass also
Rt nonhomogenous opacity sparing only apical region Bilatral hilar prominence ?Bronchopneumonia Rule out TB CT thorax
consolidation R mid zone & lower zone + ? pleural effusion R dd pulmonary tb ? pulmonary oedema R side
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