Case of the day

Miliary Tuberculosis.

Miliary TB. Chief Complaints A 47 yr old male attended Mopd with fever and productive cough since 15 days. No associated chest pain.vomiting,SOB,palpitation,night sweats,wt loss etc. He is a K/C/O T2DM and Gutka chewer. No H/O HTN,Thyroid disorder or any significant past H/O or Operative H/O. His General Examination was normal. Systemic Examination was normal except diffuse coarse crepts in b/l chest. He was done CXR immediately which showed diffuse non homogeneous opacity..more like millets and rt upper zone consolidation. Pt was admitted and routine Ix was advised,Conservative treatment was started. He is CRP positive, Raised ESR of 157,Sputum for AFB positive. Rest reports are normal .COVID RTPCR Neg. ATT has been started from today.

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Discreet fibronodular infiltrates bilaterally all over chest with AFB positive and crp raised esr are consistent with diagnosis of miliary pulmonary tuberculosis Yes ATT +inj levofloxacine Monitor rest of LFTS and KFTS which are looking normal Pt has hyponatremia compensate by inj NS Rest supportive treatment correction of anaemia and hypoproteinemia

Thanx dr Pushkar ji Bhomia
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Cavity in right mid zone Rt side paracostal haziness upper mid zone B /L infiltration PTB Ad CBNAAT Sputum exam HRCT thorax Rt PCR for COVID

CXR..STUDY.. ? KOCH'S .. NEED'S.. HRCT THORAX.. RT..PCR..COVID-19..

Tnx Dr Dinesh Gupta
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Both the lungs are infilrated extensively. AFB positive.. CRP elevated. MTB

Adv HRCT chest,send sputum for AFB CBNAAT DST,viral markers

TB R.cin450mg capsule isonex tablet ceftum 500mg tablets tossex new syrup naprodom tab moktel immune syrup

SUGGESTIVE. OF P. TB MILIARY. TUBERCULOSIS

Miliary tuberculosis (confirmed): To continue ATT. HIV test? Keep the pt in isolation as it is a open case & may infect to others. Rpt Sputum AFB on A/D till smear becomes Negative. Rich nutritious diet along with ATT.

Bilateral Koch's DD miliary tb Cbnat

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