Concluded Case

75 yrs female,kco COPD,presented with cough and dyspnea since last 10 days.off and on fever,. spo2 88% BP 140/80 mmhg.HR 96/min. bil basal coarse crepts heard. RV, HbsAg neg. ECG normal. plz interpret CXR, CT thorax and guide further management.

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Concluded answer

COPD exacerbation with pneumonia.

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opacities and consolidation on rt Lz.. Few Discrete opacities in lt lung too.. (rt lz pneumontis with pleural effusion?) TLC coumts r high 18.2 with h/o intermittent fever.. Suggestive of Ac Rt Lz Pneumonitis. Advised beoad spectrum iv antibiotics,, mucolytics iv, bromhexine_terbutaline, low dose diuretics, chest physiotherapy And o2 support,, And moreover an ABG should be taken to find the extent of respiratory acidosis..

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Rt lower lobe haziness present Left side cp angle oblitrate Both lung field hyperinflation Cardiomegaly with LVH Leucocytosis Rt pneumonia Inj augmentin 1.2gm tds IV pan 40mg Inj levoflox OD Inj deriphylin sos Cap AB Phyline 100mg BD Syp macbary xT 2tsp tds Nebulization Duolin tds Budecort BD

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Rt lz consolidation area Fever doe tlc 1800 Rt lower zone pneumonitis in known case of COPD However in COPD it will be important for us To do sputum for culture and sensitivity Because in COPD realtive infection occur

She is kco copd .present xray chest shows rt basal haziness with nodular infiltrates tlc is high more than 18000 predominantly polys I will treat her as LRTI but keeping koch's in mind start with broadspectrum and nebulisation with nasal 02

Rt lower zone consolidationlt lower zone effusion plus cardiomegaly plus emphysematous lung...lt hilar prominance.....iv augmentin iv moxiflox.....plus supportive rx

Infiltration seen in b/l lower zones (R>L) Calcified opacities noted parahilar region Raised TLC with fever and cough.. LRTI probably Pneumonitis....

It is case of right basal pneumonia,with tc very high.give some broad spectrum antibiotics,specially sensitive to betalactum producing strain.so.care gm negative aerobes.,as it is a case of c.o.p.d.other measures as usual.

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bilateral lower lobe ground glass opacity more on right could be bilateral pneumonitis; send sputum for gram stain and cultures and start antibiotics accordingly

Calcified lesions left side, opacities both lower zones, with multiple smal cavities in rt lower zone. ?old pulm tub with bronchiectasis.

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