65 m chronic smoker fever cough with expectorant decrease apetite wt loss sob lt chest pain tc 19000 ESR 110

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Non homogeneous opacity in the left hilar area.. Extending to mid and lower zone.. Suggestive consolidation.. Left hilum also prominent.. Treat intially as community acquired pneumonia.. With antibiotics and other supportive measures.. Will need cect thorax to exclude any primary abnormality in the left lung... Tuberculosis may also need exclusion by sending afb smear and bactec culture and gene Xpert plus..

rt sir we r going on that way sp afb negative no any organism on gram stain on ct report suggest mostly its chronic infective condition but could be a bronchogenic carcinoma require bronchoscopy
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Need CECT LUNG / AFB sputum examination with bronchoscopy - Left side Opacities can be ruled out after the following tests - as Dr.Poddar sir told treat it like CAP and based on reports will follow further treatment .

Homogenous opacity In left mid zone with hilar prominence. Mediastinal shift to left with compensatory emphysema of right side. Suggests obstructive lesion. Probably bronchogenic ca. Common in smokers and common in central airways. Needs CECT chest and bronchoscopy.

Left sided fibrosis mid and upper segment of left lower lobe tracheal shift towards left side . Could be Koch's or non Koch's fibrotic lesion. Endoscopy is useful

left hilar opacity with superior mediastinal widening, i guess peesentation is not acute here n pt is also having c/o wt loss so for this age CECT is definately recommended to r/o central mass n med LNpathy

Definitely mam we have done ct report says predominantly chronic infective condition could be bronchogenic carcinoma require bronchoscopy
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Lt mid zone non homogeneous opacity, possibility of cap, kochs, malignancy... sputum afb, gram stain, fungal with culture, hiv, hbsag. usg abdomen, start with antibiotic, bronchidilator, expectoration, rt side compensatory emphysema, with trachea rt side, no visible lt trachea, may be endobrochial mass or compression collpase of lt midlobe

lt mz non homogenous opacity with lt uz cavity ,? ptb with secondary infection , sputum afb , sputum cs, cect and bronchoscopic evaluation of lt lung pathology

Pulmonary koch's left, advised AKT.

first of all T B. sputum for AFB. if negative think of malignancy and refer for CT C.and bronchoscopy.

Send sputum for afb, gram stain and culture first possibility tb if sputum negative then cect thorax and bronchoscop

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