43 female.having seasonal cough dyspnea,fever lasts for 2to3 months,on bronchodilators,takes regular influenza vaccine yearly. h/o PTB in 2015,taken complete AKT. routine lab is normal,ct &serial cxrays displayed.sputum AFB negative. plz discuss management.
Fresh xray of 26 10 18 shows calcified infiltrates in rt lower zone near chestwall with resolving pneumonic patch sequele of pultb with global EF is 50 to 55 % which is main cause of dysponea rather i should call it c/o cardiac dysponea it should be further evaluated . Rx with antibiotics and nebulisation diuretic should be added
Calcified foci and scarring right lower lung. Hyperinflation of both lungs. PTB sequele COPD
Bilateral emphysematous lung field with Bilateral infiltration with nodular opacity. Rule out for Sputum for AFB Sputum for CS Sputum for CBNNAT Sputum for fungal element Most Of the time patient not given proper sputum sample only split in sample. Repeat test for sputum. Broad-spectrum Antibiotics Tab Augumentin 625mg TDs Tab Deriphylline 150mg BD Tab levocet 5mg HS Cough expectorant Cont . inhaler Nebulization Symptomatic and supporting treatment
Copd Tree in bud suggest tuberculosis or bronchiolitis Bronchodilator Vaccinations Rehabilitation exercise
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Post TB Obstructive airway disease, Recurrence to be ruled out
Copd Rt lwr zn In view of 2..3..month fever tb should be kept in mind
Calcified nodule. RT lower zone.post Tb sequae...Treat as COLD
PTB COPD Hyperinflation of both lungs seen. Calcified foci and scarring right lower lung.
Bilateral bronchiolitis(tree in bud) with Rt middle lobe multiple calcified nodules...CRP/ESR/ procalcitonin and sputum GeneXpert ,fungal stain and aerobic culture to rule out active infection
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