RT HYDROPNEUMOTHORAX WITH UNDERLYING COLLAPSE -CONSOLIDATION.. KOCH'S

30 years female with RT sided pleuritic chest pain, dry cough, high grade fever, weight loss since last 2 weeks, ESR is 94, CRP is 66. Her vitals are stable including normal O2 saturation. Give your valuable opinion for diagnosis n treatment for this patient. Her X ray is as shown below.

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Hydropneumothorax rt side Rt mid fissural effusion Rt costophrenic angle is obscured and rt dome is not seen due to homogeneous opacity in rt lower zone Pt has highesr with h/o fever breathlessness and wt loss Adv tapping for diagnostic and therapeutic treatment Likely a c/o pulmonary tuberculosis with sequele
Thanx dr Dinesh Gupta
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1st cxray shows oblique fissural effusion, rt pleural effusion with basal collapse consolidation. 2nd cxray shows hydropneumothorax (with mod pneumothorax) Needs ICD Fluid analysis considering/ bacterial tubercular empyema. Further management accordingly.
I agree
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Bilateral parenchymal infiltration Left mid nd ll Heziness Rt ll inhomogenious opacity wth fluid level Sugg hydropnemothorax rt Diagnostic tapping wth further evaluation
RT side hydropneumothorax ask for Blood SUGAR HIV Sputum for AFB CBNNAT TB platinum, Aspiration of fluid and send for investigation Most PROBABLY a case of Tuberculous
SUGGESTIVE OF RT .. HYDROPNEUMOTHORAX NEEDS. FURTHER EVALUATION
Auscultation? RT side USG can be done to see the amount of pleuritic collection if any-tapping sos. Amoxclav/azee & cephalosporin,neb ,acetylcysteine.bronchodilator SOS,doxolin sos X-ray:pleural effusion rt, bronchiectasis lft>RT. Though spo2 is normal,neb od can b given.