55 yrs female,c/o productive cough nausea and rhinitis since 3 months.not responding to bronchodilators no h/o fever.w t loss,non dm non htn. occ wheezing. sputum examination reports awaiting. plz interpret and guide.

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X-ray shows parahilar prominences (irregular) HRCT shows diffuse septal thickening b/l lung fields with groundglassing... Bases are relatively spared My dd is- 1) Chronic Hypersenstivity pneumonitis 2) Subacute HP 3) Subacute form of ILD Do Serum IgE and try to find out any offending allergen responsible.. Do PFT and see the pattern...

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Given xray chest and hrct seems normal study including hemogram except raised esr In my opinion she is simple case of allergic bronchitis and should be added fexofenadine180mg +monteleucast 10mg at bed time with nebulisation with duolin+budecort since cough is productive I would like to give short courses of antibiotics such as Amoxyclav or Azithromycin . Yes if any offender can be traced than it will be better. Otherwise in general i will like to give her inj histaglobe 1cc s/c weekly and tapering in phases.

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Imaging is good...rule out any drug hist like ACE inhibitors for cardiac reason..if chronic rhinitis is there with nausea i wd investigate for sinusitis too..any sinus tenderness and imaging for that...also even if eosinophils are good and in case sputum reports come out to be normal i wd also think for worm infestation i/v/o occ wheeze...

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

It seems an allergic condition you should use long term antihistamine course with corticosteroid s and a nasal spray CBC (AEC)

bilateral micronodular opacitiea with ground glass opacity; could be early ILD ; do pft if possible with lung volumes and dlco

Eosinophilia ,tropical? Will respond to DEC 100mg tid for 15days.short course of steroid will work magical results.

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I will treat as as allergic bronchitis. Anihistaminic with inhalator

Agree with Dr Hardik Ahuja.

thnkyou Dr Ashok
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Copd emphysema cardiomegaly lt basal pneumonitis tapping cbnat 2 decho

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