C/O : Productive cough and fever.

Chief Complaint A 26 y-o male complains of productive cough and fever. History He has h/o Asthma and was taking an inhaler. Examination Pulmonary and Cardiac examination is normal. Mild swelling was noted in the lower limbs. Investigations CBC normal. Inflammatory markers, ESR & c-reactive protein raised. Chest X-ray shows opacification in the left middle lobe. CT shows mediastinal and hilar lymph node swelling Treatment Need your valuable opinion on this.

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Possibly secondary infection. As duration of symptoms are not mentioned, consider sputum examination Gm Zn CBNAAT bacterial culture and sensitivity test. Start broad spectrum antibiotics mucolytics steam inhalation chest physiotherapy.

D/D-1-Tubercular pneumonia. Covid 19 sars2. Advise-1-sputum exam for AFB and cb natt. 2-sputum culture and sensitivity test. 3-Rt PCR for Covid 19. 4-HRCT thorax and CORaid score. Tt according to reports. Till conservative tt with broad spectrum antibiotics.

? PULMONARY KOCH'S.. ? VIRAL.. COVID-19.. NEED'S.. CLINICOPATHOLOGICAL EVALUATION WITH EXPERTS OPINION TO CONCLUDE DIAGNOSIS AND TREATMENT..

Tnx Dr Sandeep Ghodekar sir
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Likely PTB Further investigation is needed Sputum for AFB/CBNAAT HRCT of thorax LFT, TSH RT-OCR DD Lung resolution stage Covid 19 infection

As Age is 26 CRP is raised X-ray shows middle lobeopacity CT shows lymph node enlightenment, should consider first for COVID. Rt pcr first. D dimer

? Tubercular pneumonitis

POSSIBLY P. TB DD SECONDARY INFECTION.... LIKELY .. PNEUMONITIS NEEDS. FURTHER. EVALUATION

Likely pulmonary koch

Pulmonary tuberculosis

Sputum AFB And CBNAAT.. CECT thorax..

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