55/male non smoker came with cough since 1 month , fever and weight loss; sputum afb negative; interpret cxr and how to approach

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There is pulling of trachea on rt side with fibrosis and nodular swellings though sputum is negative for afb but chest looks to be kochs only go for genexpert test or cbnaat

Koch's only for genecpert test or cbnaat.
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Rotation, Bil diffuse parenchymal reticulonoduler shadows sparing left apex. ILD/ARDS/VIRAL PNEUMONIA

Pulling of trachea on rt. Side withis negative for afb but chest looks to be fibrosis and nodular swelling though spuutum

Exposure with Lt rotation , bilateral infiltration , more on rt than lt without effusion ,with field oligaemia on lt apex ? His cbc , cbnaat (tubercular), rft ,his hospitalization history (nosocomial pneumonia) any comorbidity ,many more things are missing to reach appropriate diagnosis

Overexposed film with left anterior rotation, as per the history and infiltrate present (R>L) it is pulmonary tuberculosis . Sputum for afb staining and culture with sputum for cbnaat .

Multiple consolidation of rt side suggestive of pul TB. For confirmation do CBC, ESR, repeat triple sputum smearing nd CB-NAAT.

Broncho pneumonic effusion....may be poulmnary TB....sugestive CBNAT

Thanks Dr. Partha Sarathi Sahana
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Trachea is pulled to right Fibrotic lesions seen Tuberculosis Pls get CT Chest

Thanx dr Ahmar saeed

Thanx dr Ashutosh Sharma

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