pt had exposure to pulmonary tuberculosis case in family.her grand father.c/o cough and decreased weight gain.occasional fever.non signifiacant.on auscultation bilateral wheezing and it tb or childhood is on isoniazid prophylaxis.

h/o contact cough wt loss chest signs cxr showing infiltration i would suspect Tb first with relavent work up.. if Tb ruled out then br pneumonia or br asthma should be considered.
after looking at xray and history it seems this child has infiltration on air have to treat bacterial infection with antibiotics.. meanwhile work out to rule out sputum or gastric lavage for AFB.. it doesn't look like asthma exacerbation even though known case...I dont think cardiomegaly stil can measure CT ratio....for my fellow colleagues... why we r suspecting xray is not typical of air trapping...
Dear doctor ,Go for test esr (u havent mentioned age of pt) ,if findings goes abnormal treat with AKT as per aap giuidelines .also deworm this pt. X-ray as such seems to be normal ,except mild hilar congestion ,
Cardiac shadow is enlarged and looks abnormal.. Perform intially an eccho Doppler study to exclude or confirm Any cardiac disease... Bronchial asthma is a next possibility if cardiac disease is excluded
X- Ray chest normal.
Dr Ranjit Kumar Poriya Homeopathy Patient Case History Basis Suspect *Asthma Bronchitis. * BACILLINUM 200 Weekly 1dose. X1month. * Aspedossparma 0, Aralia Resimosa 0 Is Best.
Should go for mantaux the same time sputam for afb to be checked .If this is negative then treat it as chronic bronchitis with good antibiotics.
no hyperinflation. asthma less likely. do mantoux, gastric afb . of negative may treat as lrti or bronchiolitis
as for X-ray concern, almost normal but history suggestive to rule out pul koch,s should be managed as asthma
Dr. Rahul K. Sharma sir please share your views
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