Hyperinflation in both lung fields. Hilar lymphadenopathy. Cavity in rt apex. S/o both Koch's and COPD. Spirometry and cbnaat could aid in further diagnosis.
Fibronodular cavity rt apex with haziness Not responding to given treatment Pulmonary tuberculosis Better to shift on ATT
Hyperinflation bothlungs. Infiltrations right Apex. Cardiac shadow is tubular. PTB with COPD emphysema.
TUBERCULAR INFILTRATION RIGHT APEX WITH COPD WITH EMPHYSEMA
COPD Emphysema Rt apex hazy Aortic knucle calified PTB
CXR showing B/l hyperinflation s/o COPD with a ? haziness in right upper lobe, is there any h/o exertional dyspnea in the past? PFT to be done to r/o air flow obstruction and to start on inhalers accordingly.With the present history of 10 days,cough not responding to treatment could be due to post viral reactive airway, that may respond to a short course of oral steroids R/o other causes of cough like GERD,post nasal drip,whether on any ACE inhibitors etc.Sputum AFB to be done also
Chronic bronchitis with emphysema
Right sided haziness in the apex with bilateral emphysematous appearance. ? COPD(Chronic Bronchial Asthma) with superadded right sided apical pneumonitis., Could be Koch's.
Opacity with crowding of ribs over Rt apical region and hypervolumic lungs suggestive of reactivation of old PT.
Rt apical haaziness seen B/L Hyperinflation of lungs Tubular heart COPD ? PULMONARY KOCH'S Adv Hrct chest Sputum c /s, AFB r/m LFT creat,
Bil Hyperinflated Lungs, COPD RIGHT apical haziness HRCT, Sputum for AFB and CBNATT ? TB
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Female patient at 50s presented with fever 39 c , cough , wheezy chest ,dyspneaDr. Priyank Jha32 Likes226 Answers
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A 32-year-old woman present to ED with c/o fever of unknown origin for the past 3 months. Her fever has been as high as 103°F and has had no noticeable pattern. The patient has a history of bronchial asthma and chronic bronchitis that has not responded to multiple courses of antimicrobial treatment including amoxicillin/clavulanic acid, cefotaxime, and Moxifloxacin. She has a 5-year history of asthma managed with inhaled bronchodilators and an occasional need for doxophylline. She has a productive cough (yellowish sputum). O/E, the patient is very uncomfortable and restless. high grade fever, PR 110 beats/min, BP 110/70 mm Hg, and a respiratory rate of 25 breaths/min. Examination of the chest reveals crepitations and wheezes throughout both lung fields, but normal heart sounds without evidence of cardiac murmur or friction rub are found. No cervical, axillary, or inguinal lymph node enlargement is noted. The laboratory investigations include a CBC with a hemoglobin of 12.9 gm/dL, a platelet count of 350,000/mm3, and a WBC count of 25,000/mm3, ESR is elevated at 65 in the 1st hour. The rheumatoid factor finding is positive. A plain chest radiograph is performed, which reveals multiple scattered infiltrates in both lungs. What's the likely diagnosis and treatmentDr. Z. V. Anwer3 Likes11 Answers
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14 yr old boy came with complaints of cough with expectoration since 1 month,more on the night. No h/o of fever,breathlessness,chest pain,gi complaints. He is conscious and alert. O/E bilateral ronchi heard over infraclavicular,mammary,inframammary areas.Suggest management please...!!Dr. Jithin Prakash2 Likes18 Answers
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18 yr male pt, h/o difficulty in breathng, burning in chest, loss of apetite frm 10 daysDr. Prashant Mishra2 Likes18 Answers
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Friends today I am discussing about a very serious problem most of the peoples have on change of weather. As weather is changing in these days here value of the content is important. Topic is Allergic bronchitis. Bronchitis is an inflammation in the lining of the bronchial tubes. These tubes in the lung carry air into the lungs from the mouth and nose. The swelling narrows the airway causing a cough and may make breathing more difficult. The irritation can also lead to increased production of mucus, which blocks the airway. Bronchitis can be classified as either allergic, non-allergic, or asthmatic, depending on its cause. Although the symptoms of bronchitis are similar regardless of the cause, there may also be differences, especially in how long a person will feel the effects of the condition. What is allergic bronchitis? Allergic bronchitis Allergic bronchitis occurs when an allergen inflamed the lining of the bronchial tubes. Allergic bronchitis involves inflammation of the bronchi caused by an allergen, or something to which you are allergic. Airway irritants, such as pollen, dust, and mold, can trigger symptoms. Cigarette smoking almost always causes allergic bronchitis. The symptoms of allergic bronchitis may last for a long time or keep recurring. Allergic bronchitis that lasts longer than three months is often called chronic bronchitis. This is a type of chronic obstructive pulmonary disease (COPD). Chronic bronchitis is almost always caused by cigarette smoking. Symptoms of allergic bronchitis include: a cough that produces mucus wheezing chest tightness tiredness Bronchitis can also lead to complications. For example, lung infection, such as pneumonia, can occur. In the most severe cases, pneumonia can lead to an infection in the bloodstream called septicemia. Septicemia is often life-threatening. Chronic obstructive pulmonary disease (COPD) Chronic obstructive pulmonary disease (COPD) Click here to learn more about COPD. READ NOW Non-allergic bronchitis Non-allergic bronchitis occurs because of a viral or bacterial infection. For example, some people develop non-allergic bronchitis after a cold. Although anyone can develop non-allergic bronchitis, older adults have a higher risk of experiencing the condition. People with weakened immune systems and those who smoke also have a higher chance of developing bronchitis after an upper airway infection. Symptoms often improve within a few weeks and are less likely to recur than the symptoms of allergic bronchitis. Non-allergic bronchitis is sometimes called acute bronchitis, as symptoms may onset suddenly and are typically brief. Symptoms of non-allergic bronchitis might include: a cough that produces mucus chills fever What is asthmatic bronchitis? Asthmatic bronchitis Asthmatic bronchitis can occur in people who already have asthma as an underlying condition. Like bronchitis, asthma is a lung condition that can cause breathing difficulties. Asthma can also cause inflammation of the bronchi, but can also lead to narrowing of the muscles around the airways. When bronchitis and asthma occur together, and symptoms overlap, the condition is often known as asthmatic bronchitis. Inflammation that triggers symptoms of asthmatic bronchitis might occur in someone who has underlying asthma after exposure to certain substances, such as pollen, pollution, and cigarette smoke. Some people also develop asthmatic bronchitis because of a change in weather or exercise routine. People with asthmatic bronchitis respond to these environmental triggers by releasing leukotrienes. These are inflammatory molecules. Leukotrienes cause a series of reactions, including narrowing of the airway. Symptoms of asthmatic bronchitis may include: coughing excess mucus production wheezing shortness of breath Diagnosis A doctor will diagnose allergic bronchitis based on several factors. They will review the medical history of the individual with suspected allergic bronchitis, as well as perform a physical exam, usually ask questions to determine how long symptoms have been occurring. The physician may use a chest X-ray to rule out some other causes of breathing problems, such as pneumonia. They may also request blood tests to help determine if an infection is present. The patient may also receive a pulmonary function test. This involves the individual blowing into a special device called a spirometer. The device measures how much air a person can exhale, and how quickly. The test helps doctors to identify the presence of lung diseases, such as asthma and chronic bronchitis. Treatment Treatments for allergic and asthmatic bronchitis are often similar and may include the following: Bronchodilators Bronchodilators are medications that relax the muscles around the airways. As the muscles relax, the airways dilate or widen, often making breathing easier. People take bronchodilators through a metered dose inhaler. Both short-acting and long-acting bronchodilators are available. Short-acting bronchodilators act quickly to decrease symptoms, but the effects do not last. Long-acting bronchodilators do not reduce symptoms as quickly but control symptoms for a longer period. Steroids Steroids may also be used to treat allergic bronchitis. Steroids decrease inflammation in the bronchi. This action reduces coughing and may help air-flow in the lungs. Although steroids can be an intravenous or oral medication, a physician will often administer them through an inhaler in cases of bronchitis. This allows for quicker and more effective delivery of the drugs to the area that requires treatment. Mucolytics A mucolytic drug is a medication that makes the mucus thinner and less sticky. This making it easier to expel mucus from the lungs by coughing. People can take mucolytics either orally or through a nebulizer. A nebulizer is a device that changes a liquid medication into an aerosol. A person can then inhale this aerosol. Oxygen therapy In some instances, allergic bronchitis can interfere with the efficiency of oxygen flow into and out of the lungs. People with severe allergic bronchitis may have decreased levels of oxygen in the blood. If oxygen levels are low, a doctor may prescribe oxygen therapy. This can help restore oxygen levels to normal. Pulmonary rehabilitation classes People with chronic allergic bronchitis may benefit from pulmonary rehabilitation classes. Pulmonary rehabilitation classes involve supervised exercise, along with education on how to breathe better and manage allergic bronchitis. These classes show people how to decrease exposure to allergens that may trigger symptoms. Acute non-allergic bronchitis often does not require treatment. Doctors treat asthmatic bronchitis in a similar way to allergic bronchitis, with bronchodilators, steroids, and oxygen as needed. However, acute non-allergic bronchitis may also be treated with antibiotics if caused by a bacterial infection, though this is uncommon. In some cases, a doctor may also prescribe leukotriene modifiers to treat asthmatic bronchitis. These work by interfering with the chemical reactions that cause the symptoms of asthmatic bronchitis. Home remedies humidifier A humidifier can moisten the air and loosen mucus. Many of the treatments for allergic bronchitis require a prescription. However, there are also steps a person can take at home to reduce the effects of bronchitis. Although home remedies will not cure the underlying cause of allergic bronchitis, they may help to reduce symptoms. These steps including: Using a humidifier: A humidifier will moisten the air. This can loosen mucus and make it easier to expel. It may also decrease wheezing. People with asthma should check with their doctor before using a humidifier. Drinking plenty of fluids: Drinking enough water may help keep mucus thin. Gargling with salt water: The coughing from allergic bronchitis can lead to a sore throat. Gargling with salt water might ease discomfort. Taking a cough drop: A cough drop may keep the throat moist and can provide relief from coughing. Click here to choose online from an excellent range of humidifiers with thousands of customer reviews. Prevention Preventing allergic bronchitis usually involves avoiding irritants, such as chemical fumes, dust, and air pollution. Prevention of asthmatic bronchitis includes both avoiding triggers and managing your underlying asthma according to the plan developed with your doctor. Cigarette smoke is one of the leading causes of allergic bronchitis, so quitting smoking, or not starting at all, is one of the best ways to prevent the condition. If outdoor allergens, including pollen or mold, tend to cause allergic bronchitis, wear a mask when carrying out yard work. This might also prevent symptoms. BEST HOMEOPATHIC MEDICINES FOR ALLERGY Arsenic alb - There is thin watery discharge from the nose with burning sensation, recurrent sneezing one after another with runny nose. Burning and tearing of eyes . There is puffiness around eyes, stuffy nose. The person has an asthmatic tendency with breathing difficulties, and oppression of chest which is generally worse when he lies down. On sitting with a forward bending posture makes the patient little comfort from his asthmatic problem. There is marked wheezing sound during asthmatic affection. The asthma is worse in wet cold weather. Besides that the constitutional symptoms of arsenic alb are anxiety, restlessness, prostration, burning sensation. The anxiety that is found in Arsenic alb is intermingled with fear. The other prominent symptoms are debility, exhaustion, restlessness, with nightly aggravation. Great exhaustion after a slightest exertion. Sulphur – There is itching with redness of eyes in allergic condition. The itching is followed by burning sensation and relieved by cold application. sulphur patient is always irritable, depressed, thin and weak, but good vappetite. He is having forgetful nature, difficulties in thinking. He has many good ideas but cannot implement it. Selfish type person, no regards for others. very lazy person, not cleanness, never look after about his dressing and clothing. Don’t like to take bath. Having of skin diseases always. The skin rashes itch a lot generally in night and warm atmosphere. The person has a feeling congestion or oppression of chest in asthmatic condition.– Natrum mur – Natrum mur is generally well indicated in case of allergic condition which gives the symptoms of more itching of nose, throat, ear with recurrent sneezing one after another. The characteristic discharge from the mucous membranes is watery or thick whitish, like the white of an egg.Natrum mur patient is very sensitive in nature. Every thing he/she takes into the heart. The person is irritable in nature and when in upset does not like any body’s present or giving of any consolation.Consolation aggravated the state of the mind - the melancholy, the tearfulness, sometimes brings on anger. The Natrum mur patient is extremely emotional. The whole nervous economy is in a state of fret (visible anxious like scratching finger on her skin in worry). Completely or desperately in love brings on complaints. The natrum mur patient desire to take extra salt in his diet. Sabadilla- it has good action on mucous membrane of the nose and the lachrymal glands, producing coryza and symptoms like hay-fever. There isspasmodic sneezing one after another. symptoms of hay-fever or allergic rhinitis with itchy nose and fluent coryza. Either nostril stuffed up, inspiration through nose labored, snoring. Violent sneezing is occurred from time to time, shaking abdomen followed by lachrymation. There is runny nose with severe frontal headache and redness of eyelids. Allium Cepa Allium Cepa is one of the most commonly used Homeopathic medicines for Allergic Rhinitis or Hay Fever. It is generally used in the symptoms of severe runny nose that drips from the tip of nose with watery eyes. There is burning of nose due to over secretion mucous. Along with the watery nasal discharge there is watery eye. There is profuse sneezing associated with runny nose and watery eyes. Tuberculinum- The patient is very susceptible to catch cold. The physical constitution is lean and thin like natrum mur, but not obese like calcarea carb. If there is family history of tuberculosis or bronchial asthma then is more suitable to give this medicines in any allergic or asthma condition. The person is very depressed, melancholic, taciturn sulky nature.Dr. Rajesh Gupta16 Likes25 Answers