Concluded Case

Right Pleural effusion

A 38 years female with history of cough and fever for 2 weeks with SOB After routine treatment with antibiotics for 2 weeks- cough and SOB was not settling . As per the protocol - any cough which do not resolve after 2 weeks- X- ray should be done . X- ray done today was surprising . Aim of this post is to ensure that any cough and fever for 15 days - X - chest should be done . Comments on X - ray and the case

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Concluded answer

Moderate pleural effusion seen on rt side and mediastinal shift towards contralateral side. LVH noted. Rt sided therapeutic pleurocentesis. ECHO CD and fluid analysis.

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Moderate pleural effusion seen on rt side and mediastinal shift towards contralateral side. LVH noted. Rt sided therapeutic pleurocentesis. ECHO CD and fluid analysis.

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Moderate Rt. pleural effusion with lungs abecess, mediastinal shifted towards left sided, hydropneumothorax, PUT ICD & taping fluid & must send for R/M or analysis do cbc esr, serum ada, cbnatt, hrct chest, afb. 2d echo.

Absolutely it is a c/o massive pleural effusion rt side and relief can not be given without tapping so put on ICD Send aspirate for analysis Absolutely your purpose of following protocols appriciable But in modern era it rather earliest investigations are more supportive in dx Specifically covid era where you can notice as early as 3to4th day Well done Xray chest shows massive pleural effusion on rt side lower and mid zones pushing trachea and mediastinum to lt thus collapsing lt lower zone Without tapping difficult to see any lesion as viualised lung fields are clear D/d could be pneumonitis with pleural effusion Or tubercular

Thanx dr Satish Kumar
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Yes ..for any cough nd fever nt responding to treatment Chest Xray must be done.. X ray shows Rt hydropnemothorax wth Mediastinal shift to left Need Pur Rt ICD for therapeutic nd diagnostic pleurocentesis.

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Hydropneumothorax, right Mediastinal shift to left Suggest HRCT, ICD to left pleural space ? TB Sputum for AFB and CBNATT Pleural aspirate analysis for AFB and CBNATT and ADA and culture and routine tests .

Thank you, Doctor
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Massive plural effusion RT Lung, Aspiration and send fluid for investigation, CBC ESR Blood SUGAR HIV Sputum for AFB CBNNAT TB Gold

I am agree with@Dr. Krishnan Pichumani Sir.

Thank you, Dr Pranab Bera
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As the duration is short infection is likely either bacterial or tubercular. as pt already took antibiotics 2wks and not responding tubercular etiology most likely... pleural fluid study gives u the clue.. after therapeutic drainage a ct thorax can be done in order to exclude other etiology.. what about blood parameters...

Hydropneumothorax

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