Concluded Case

neoplasm of lung

55yrs old male farmer prior history of denovo diabetes on insulin and chronic alcoholic (no other co mordities). Brought to hospital with complaints of fever associated with chills since 25 days..( not subside with medication). History of non productive cough since 20 days.. H/o.shortness of breath ×( grade 2-3) since 15 days.. Loss of appetite and generalised weakness.. On Examination- Temp -102f ,BP- 90/60 mmHg, PR - 121/min , GRBS -170mg/dl ,spo2 - 93% RA.. CVS - S1,2- normal Lungs- crepitatoons on right basal.. CRP -79mg/dl , ESR -110 mm ,HBA1C - 11.8% VDRL -Positive ( other viral markers negative) sputum for AFB,gramstain culture,cytology - report awaiting CBNAAT - negative RFT,LFT ,usg abdomen-normal.. Planning for biopsy . Treatment started with.. broadspectrum antibiotics plus macrolides... ,Anti histamine, anti pyretics ,nebuliser, hydration , insulin sliding scale with GRBS levels.. Any suggestions..?

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thank you for ur valuable opinions.. supportive treatment given and contrast CT CHEST shows lesion with variable size subpleural extend to mediastinum with lymphnode metastasis.. refers to medical oncologist..for further management

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thank you for ur valuable opinions.. supportive treatment given and contrast CT CHEST shows lesion with variable size subpleural extend to mediastinum with lymphnode metastasis.. refers to medical oncologist..for further management

Add clindamycin Sputum culture sensitivity If no conclusion BAL gm stain culture Lastly biopsy if no result

Leucocytosis 35120 Uncontrolled hbA1c over 11% Hrct significant of rt lower lobe superior segment consolidation Hence looks to be a c/o acute atypical pneumonitis Beside continue good control of bsl Inj piperacillin tazobactum 4.5gm 6hrly Inj ceftriaxazone Inj dexamethasone Inj pantaprazole Inj ondestron Inj paracetamol Rest supportive treatment orally

Thanx dr Dinesh Gupta
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Acute viral infection? With rt sided heart failure. COVID-19 RAT/ RTPCR. STUDY CARDIAC PARAMETER LIFE SUPPORT MANAGEMENT.

HRCT SHOWS SOFT TISSUE LESION OCCUPYING THE SUPERIOR SEGMENT OF RIGHT LOWER LOBE . ?? LOBAR PNEUMONIA. ?? NEOPLASM. DO, USG GUIDED BIOPSY. COVID-19 RT-PCR. BLOOD C/S.

NEEDS CULTURE. AND SENSITIVITY AS SpO2....93%. IS. WNL. AND FEVER. CHILLS. NOT. RESPONDING. ....TO. ANY. MEDICATION. FOR. THE. LAST.....*25*. DAYS

Rt basal hazyness pl rpt after a course of antibiotics

NEED'S .. CLINICOPATHOLOGICAL EVALUATION WITH .. RT..PCR..COVID-19 .. HISTOPATHOLOGICAL EVALUATION ..

Tnx Dr Dinesh Gupta
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If lesion remains refractory, may consider CT guided biopsy HPE to differentiate between neoplastic vs Infective etiology.