Case of the day

Differential Diagnosis and Furthur line of Management ?

25 yr old female presented with c/o cough with sputum for 2 months, SOB for 2 wks, Chest pain for 3 days. H/o weight loss present. No H/o ATT in the past. pleural ADA - 33 @Sandeep Ghodekar CT chest , sputum AFB , Blood reports are included. Kindly give furthur line of management.

(Edited)

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Cxray shows rt middle and lower lobar consolidation. CT thorax showing perihilar heziness. No Pleural effusion appreciated. WBC are normal No -AFB On sputum. CRP normal ESR not much raised. Adv Sputum Gm stain, fungal koh, and CBNAAT. And respective culture sensitivity test. Consider atypical pneumonia/mycobacterium. May start broad spectrum antibiotics and mucolytics for a week. ICS LABA combination Further management as per Sputum examination.
Thank you doctor
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Indicates Pneumonia. Radiological opinion also concurs the same- it shows. Since the symptoms are sub chronic, it is better to rule out the conditions such as DM and HIV. Broad spectrum antibiotics for 2-3 weeks (based on response) may be considered. Please update
Pleural ADA - 33
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PTB. Rt paracardic region has dense opacities and haziness. Needs further investigation and evaluation to conclude and treatment plan. TILL reports complied BS ANTIBIOTICS orally. Antihistamine orally. Mucolytic cough syrup. Analgesic SOS.
Thanks Dr Sandeep Ghodekar
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Rt paracardiac region has density with haziness long standing history of cough with expectoration and wt loss Esr slightly raised Ada 33 All indicates likely c/o tuberculosis
Thank you doctor
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Sputum for CBNAAT. Possibility of PTB to rule out. Treatment accordingly.
Thank you doctor
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Is there pleural effusion????
Yes
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
Right LL pneumonia. Get COVID, Sputum gram stain, c&s.CBNAAT. HIV test Start broad spectrum antibiotics,antifungal.
Sir pt has fever history , lymphadenopathy PCR TB test If indicated then start empirical AKT
Sir she has fever history,PCR TB test done ,is their any lymadenopathy
No h/o fever
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