What will be final diagnosis

male /8yr , coughing with dry , breathlessness , fever since 4 days pleural fluid cyto bio report , lymphocytes predominant , total cell 540 , Att started since 6 days Therapeutic tape done approx 500 ml ,. still x-ray not improving please suggest

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Massive pleural effusion with mediastinal shift towards contralateral side. At least 2 to 2.5 lit fluid is expected. Partially drained. Put in a ICD on left in view of complete evacuation of fluid. Continue AKT for 6 months. Post ICD CT thorax to see for parenchymal involvement.
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Xray haziness of lt lung Suggestive of pleural effusion Tapped pleural fluid cytology lymphocyte predominant Culture of tapped FLUID for culture for AFB. and CBNNAT AS ATT stared pleural effusion may resolved and it shows improvement continue ATT.
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Adv: fluid CBNAAT to confirm Pul Kochs Wait for 10 days more usually Kochs effusion resolves on it’s own If more fluid then further tapping done If clinically patient improves with AKT Then wait Other wise search for other reasons
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SUGGESTIVE OF PLEURAL EFFUSION... .. ADVISABLE... ..C. S. T......AKT. NEEDS. FURTHER. EVALUATION
Agreed with Dr.Mrinal K Pal.

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