75yo male with #COPD compalints of 1 week of productive cough with progressive dyspnea and fever with chills. What is the diagnosis of the x-ray and treatment??



Miliary Mottling evident on x ray. Possible Differential. . Miliary Koch's which is most likely. Other possibilities to keep in mind.. Fungal causes like Coccidiodomycosis, Blastomycosis which are generally associated with HIV associated opportunistic infections. Lymphangitis Carcinomatosis Chemical Pneumonitis Sarcoidosis Pneumoconiosis, Pulmonary Eosinophilia, Acute form of IPF, Etc. Out of all these Miliary Koch's is most likely. Get HIV, Sputum AFB, CBNAAT, CECT Thorax.. to confirm the diagnosis.

At age of 70, if military then Diabeties to be excluded. Please mention SpO2.

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CXR finding suggestive of miliary tuberculosis. CT scan thorax and fundal examination for choroidal tubercle and CBNAAT for AFB maybe done if available. There should be no delay in treatment .start ATT immediately.

It's a case of pneumonia.

miliary Koch's, go for sputum n ct to confirm

Miliary tuberculosis.

Look like miliary appearance wth opacity of ryt mid zone may be jst because of pneumonia. So 1st of all treat consevatvly for pneumonia wth iv antibiotic n copd wth complete work up for any active tubercular lesion

Rule out TB. Do sputum test, we ADA, Do ECG . Manage with Bronchodialator Mucolytics Antibiotic After sputum test if TB go for ATT

Small multiple round opacities in both lung suggestive of milliary tb

Military Tb/lymphangitis carcinamatosis

Looks like Miliary TB, confirm with sputum examination and ct correlation

Sputum AFB is usually negative in case of Miliary Koch's.
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