Concluded Case

Bilateral Pulmonary Tuberculosis

34 yo male H/O cough with expt, low grade evening fever, wt. 34 kgs. No family history and previous history of illness. CXR follows and further tests required are taken. Any special test in the opinion of experts is solicited.

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Concluded answer

Left lung field is showing reticulonodular opacities in its entire extent with shift of mediastinum to left Right lung field is clear This X ray chest is highly suggestive of pulmonary Koch's Adv Sputum for AFB, Gene Xpert for TB and TB culture

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CXR shows 1.Hyper- inflated right lung 2.A raised right dome of diaphragm 3.Few bronchiectatic lesions are seen in the right upper zone 4.left pulmonary parenchyma is destroyed, there is volume loss and extensive cavitatory lesions and reticulo - nodular opacities 5.Mediastinum is shifted to the left due to hyperonflated right lung and collapse of left lung 6.Cardiac shadow is not properly visualized. DIAGNOSIS most likely is a sequelae of extensive PULMONARY tuberculosis May be associated bacterial and fungal infection. History of cough with expectoration , low grade fever with evening rise , significant weight loss is also in favour of PULMONARY tuberculosis. Further investigations required are 1.Sputum for AFB and Genexpert testing to rule out MDR or XDR tuberculosis. 2.Sputum for culture for tuberculosis on L.J Media . 3.HRCT ATT to be started whether category 1 or 2 depends upon the investigations

Rt sided hyperinflation Few bronchiectatic lesions seen. Left sided destroyed lung with volume loss. Mediastinal shift towards left side. Possibly Koch's sequelae with relapse or superadded infections. Needs evaluation.

Right lung hyperinflation seen Right upper zone fibrobronchiectatic lesions, with fissural effusion Left lung almost completely destroyed with extensive fibro bronchiectatic and cavitatory changes. RT hilum pulled up. ,Right dome elevated. Bilateral PT ,? MDR TB Sputum for AFB and CBNATT and fungus. To rule out DM and HIV.

Thank you,Doctor
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Left lung field is showing reticulonodular opacities in its entire extent with shift of mediastinum to left Right lung field is clear This X ray chest is highly suggestive of pulmonary Koch's Adv Sputum for AFB, Gene Xpert for TB and TB culture

CXR.. * RT. LUNG HYPERINFLATED.. * LT. LUNG.. ALMOST COMPLETELY DESTROYED WITH VOLUME LOSS.. * MEDIASTINAL SHIFTING TO.. LEFT .. ? PTB.. SEQUELAE.. NEED'S.. HEMOGRAM.. SPUTUM STUDY.. CBNAAT.. HRCT..

Tnx Dr Neeladevi S
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Pulmonary tuberculosis with left lung scarring *Experts opinion on other findings and treatment

X -ray chest reveals gross reduction in Volume . Infiltration in all zones with few cavities. HIV has to ruled out .

Miliary Tuberculosis with plural effusion

? Pulmonary koch's.. Investigation.. Hemogram.. Sputum study.. Hrct..

Sputum for CBNAAT and hrct thorax

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