A young male with Dyspnea

A male aged 28 years Chief Complaints Gradually progressive Dyspnea (x 2 months) Cough Fever (x 10 days) Physical Examination Decrease air entry left infra-axillary & infra scapular region B/l Rhonchi

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Rt sided loculated pleural effusion Air fluid level seen possibly intestinal obstruction. RT in situ. Left sided pig tail catheter seen Few artefacts and ? Misplaced rt cetral line.

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Right side loculated pleural effusion with left minimal effusion with left side nephrostomy tube in situ. Adv Usg thorax and pleural fluid aspiration. Send samples for ADA, Biochemistry, cytology, Genexpert ,Afb smear,Pyogenic culture.

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