Concluded Case

Copd

75 y/f kco copd taking budecort n asthalin inhaler Chief Complaints Sob since 3 days History No h/o fever,cough Vitals Afebrile Hr 104/m Bp 108/62 Physical Examination No sound on auscultation in left lung Crepts in rt lung Investigations Cxr CBC..normal Est ,70 Tlc 11900 Diagnosis Copd Management i gave hydrocot 200 mg iv stat Inj dexa 8 mg i.v. Neb with asthalin n budecort. Pt feel relax n send for cxr n inv. Today cxr came .Kindly give ur valuable opinion how to manage is?

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Concluded answer

Blood counts suggest infection. Xray shows left hydropneumothorax. He will need antibiotics, bronchodilators and keftintercistal drainage tube with under water seal. Send sputum for AFB and routine culture, pleural fluid for chemical and cytology tests.

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Lt side chest shows hydropneumothorax Rt side lower zone shows floppy swelling likely pulmonary oedema and fissural effusion Tlc shows mild leucocytosis But esr is 70mm D/d 1 tubercular 2 covid19 infection

Thanx dr Mrinal Kantil Pal
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Blood counts suggest infection. Xray shows left hydropneumothorax. He will need antibiotics, bronchodilators and keftintercistal drainage tube with under water seal. Send sputum for AFB and routine culture, pleural fluid for chemical and cytology tests.

Valuable opinion
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It is a case of pneumothorax lt side with ? Opacity lt lower zone may be due to consolidation. Rt side there is broncho vascular markings prominent and slight pneumonitis.

I agree
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CXR .. COPD.. NEED'S.. HRCT.. RT..PCR..COVID-19.. SPUTUM STUDY..

Tnx Dr Shivraj Agarwal sir
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SUGGESTIVE. OF .PNEUMOTHORAX ...LT. SIDE WITH PNEUMONIA

Left pneumothothorax Right tracheal shift

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Rt sided diffuse parenchymal reticulonoduler opacities seen. Rt parahilar rounded opacity with soft infiltrations seen. Few calcified opacities seen. Lower tracheal deviation towards right side. Left sided hydropneumothorax noted. Left paracardiac lobulated shadows seen. Possibly Lung collapse. Adv left ICD. Send pleural fluid for routine ADA CBNAAT cytology bacterial culture and sensitivity test.

Trachea is pushing to right side with irregular margin of left lower lining with RT. Side patch with hazziness with infiltrates seen & left lung is hyperlucent Go for HRCT for pathological findings Sputum for AFB sent

Xray shows copd with ground glass opacity See for hrct See for ecg with 2decho See for blood report and electrolyte See for covid profile n swab N treat accordingly