Concluded Case

62 yrs male presented with cough dyspnea fever since last 10 days. spo2 82% Bp140/80mmhg HR 108/min. bil fine crepts and wheezing present. started NIV sat reched to 94%. clinically improved but spo2 remaining around 94to95%. started antibiotics diuretics bronchodilators mucolytics antiviral treatment. lab cxray CT thorax and echo is attached. plz comment.

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B/l patchy consolidations.. Viral pneumonia or aip (ild) are my picks..steroids will help if patient not responding to anti virals
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INFILTRATIONS CARDIOMEGALY LT. DOME. OF. DIAPHRAGM.... IS. HIGH. PLACED MARKED. IMPROVEMENT. IN SUCCESSIVE. X. RAYS
Koch's chest B/L lungs opacity seen and cp angles obliterated. ATT Multivitamins and antioxidants orally. Good nutritious balanced diet and plenty of liquid daily. Improve general health and personal hygiene.
Thanks Dr Shital Jadhav
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?Pulmonary koch's ........ If fever & DYSPENA with cough persist after giving antibiotics also then some more investigation should be done like Sputum for AFB satin , Gram satin,ESR. Ask about past history related to TB. Any additions like tobacco, smoking nd alcohol etc. If there is any such type of history is there then bronchoscopy should be done and the Lavag should be check for culture sensitivity...
Opacities seen in right lung midzone and base Infiltration left midzones and base Unfoding of AORTA, Cardiomegaly Considering 1) short duration of illness - 10 days 2) Normal total white cell count 3) Early respiratory failure- Low SPO2 4) elderly patient It is likely that this is viral bronchopneumonia Suggest investigations to rule out KOCHS .
There is tenting of dome of diaphragm b/l Basal congestion b/l rt is more than lt Pt is hypoxic. 2decho is normal You are on right line as successive xray shows marked improvement Pt is hypoxic bcz pulmonary oedema and PAH continue for some more time pt will come out basically he is pt of copd
Thank you Dr.
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Rt CP angle obliterated bilateral basal Koch's rare broncheictasis 2 d normal esr 3 day sputum AFB gene expert culture & sensitivity
B/l patchy consolidations.. Viral pneumonia or aip (ild) are my picks..steroids will help if patient not responding to anti virals
B/L lung fields opacities seen. Mild Cardiomegaly present. Hb is low. Start haematinics to improve Hb. Do anaemia profile.
Left dome of diaphragm high placed. Infiltrations present both lower lungs. Cardiac shadow is enlarged.
Thank you doctor
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B/L diffuse fibronodular infiltration predominantly basal areas RT cp angle obliterated PTB
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