55/M presented with c/o Left sided chest pain n mild breathing difficulty of 2 days H/O low grade Eve fever,loss of appetite n weight from 3 weeks Chronic Bidi smoker Smoked 10-15 bidis a day for 30 yrs Non alcoholic No h/o any significant illness in the past Farmer by occupation Clinically he had diminished breath sounds over left MZ n LZ My provisional diagnosis was Left MZ-LZ pleural effusion,probably Tuberculous But I was shocked to see the CXR



left side massive pleural effusion with mediastinal shift. as history suggest do sputum AFB, pleural fluid aspiration for therapeutic &diagnosis. biochemistry of pleural fluid and microscopy for malignant cells, HCRT of chest tt according to dx. .

HRCT is must to rule out malignancy

Massive pleural effusion left side . Pleural aspiration and sent for cyto chemical exam and ADA test and for malignant cells. Might be pyothorax, advised CT chest for any malignant pathology

An ideal case for medical thoracoscopy and guided pleural biopsy if available at your set up. As differentials include tuberculosis vs. Malignanancy. Medical Thoracoscopy/pleuroscopy is done under local anaesthesia with sedation. Will be diagnostic as well as therapeutic in this case.

To summarise Pleural Fluid was s/o Exudate ESR 60 n CRP positive Though ADA was negative,considering Patient's low socioeconomic status,smoker,geographically tuberculous endemic country, Patient has been started on AKT4 Any other suggestions Curofyians

Massive left pleural effusion with mediastinal shift to right.

Massive pleural effusion Lt side with mediastinal shift towards Rt.side. Most likely tubercular. However malignancy should be ruled out by tapping, both therapeutic and diagnostic.

Icd insertion left side Send pleural fluid for all routine investigation and cytology And for confirmation of diagnosis.. Thoracoscopy and pleural biopsy should be done Search for any lymphadenopathy

Lt massive pl effusion. Pl fluid study.Looks malignant first possibility.Could b mass Lt hemithorax.

Massive plural effusion wth mediational shift to rt.inv AFB plural fluid aspiration for dx &therapeutic rest of things agree wth dr nath.

Tuber cular pleural effusion.check Ada . possibility of malignancy .atelactasis

Load more answers

Diseases Related to Discussion