40 y/o male with no h/o smoking/DM/HTN, stonecutter by profession, complains of progressive shortness of breath for 10 years, dry cough for 7 months and generalized weakness for 7 months. Dx?



Rotated , underexposed , taken in expiration film. White shadow in Rt mid and upper zone with air bronchogram visible. At the same level fibronodular lesion from mediastinum . In the left side in mid and upper zone there is nodular shadow associated with ground glass appearance. There is no increase in lung volume supposed to be no effect of smoking . Rt costo phrenic angle is obliterated due to effusion. So the patient is having silicosis with ILD in the left side , post primary tubercular lesion in rt side associated with rt pleural effusion. Adv digital x Ray . A B G , sputum for AFB and USG rt pleural cavity.

Bilateral consolidation bilateral basal effusion copd emphysema Ards history pneumonia with copd with Koch's dd pneumothorax

it's silicosis causing pmf..progressive massive fibrosis...

in such cases silico tuberculosis Co exist... so always send sputum afb 6 wk culture in such cases...

P Koch's. Sputum test for AFB Heamogram ESR PPD test. PFT. HIV test. Rx ATT as per body weight Cap Pantaprazole OD Tab B 6 OD. Tab Deriphyllin RT 300 BD. Tab Montelakast OD Tab Multivitamins OD Syrp cadiphyllate 2tsf for TID. ATT as per RNTCP guide lines. and other drugs for 3 weeks. Stop smoking Healthy diet and Rest is advised.

Pleural effusion right with bilateral pulmonary koch's.

Rullout covid 19 Investigate 1. Rtpcr 2.hrct thorax 3.d.dimer 4. Crp. 5. Ldh 6. Sr creat 6.cbc 7. Afb sputum

Bilateral pulmonary tuberculosis.

progressive massive fibrosis showing bilateral upper lobe mass like consolidation,hilar prominence and right pleural effusion possibly superimposed active infection may be present

this is occupational health hazard. ILD.

silico tuberculosis

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