patieint came today morning with history of fever cough general weakness .loss of appettite since 1 month heamogram normal ESR raised .....bs wnl ..urine analysis nad ...hiv neg ...xray atteched spot dx....investigation profile. tx

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clinicaly it us rt sided pleural effusion most probably in India common cause is tuberculosis.age of pt is not mentioned .also h/of contact with t b patient must be asked. rest it is vommon like tapping the effusion gor diagnostic purpuse. like routine for AFB gene expert ADA. for malignanacy particularily if pt is old.once tapping is done start emperically with anti kock treatment minimum with 4 drugs like Inh rifa pyrazinamide etham butol and moxiflaxacin.Imp along with predinisolne.further treatment will depend on gene xpert and culture for AFB if it is Posetive.

Bilateral apical fibro cavitatory lesion.. More so on the left side with evidence of hyperlucency of the left lung suggesting emphysema... Right costo phrenic angle blunted.. Indicates pleural effusion... Likely diagnosis tubercular.. Usg guided pleural aspiration is needed send for analysis esp cell type and count and Ada... I feel it will diagnose the cause of pleural effusion... Regarding the fibro cavitatory lesion in the apical area activity is to be assesed by sending sputum for AFB smear and bactec culture and gene Xpert plus...

Cxray is suggestive of bilateral upper zone consolidation with cavity in rt upper zone with rt lower zone consolidation and rt pleural effusion.. pleural fluid investigation for ada.. pcr.. cell count.. ldh.. protein.. cytology if older age pt... sputum examination.. for afb and cbnaat..

exactly what I have done you mentioned nicely .I sent all these investigations and started ATT with livoflxacin with other supportive treatment ..thanks
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rt pleural effusion ?TB CBP; mantoux test; ESR; pleural fluid analysis to know etiology of effusion and confirm if tuberculous in origin; TB PCR; TB quantiferon gold assay; sputum for AFB grams stain and c/s

Rt sided pleural effusion. Esr is increased. Aspirate pleural fluid and do cytological examination to differentiate between transudate and exudate. Sputum for A FB. Treatment depends on cytology reports.

rt sided plural effusuion with pul kochs do dignostic tapping ADA RM CS malignat with fungal cell AFB sputum for AFB TB PCR

rt.lower zone consolidation with pleural effusion,,,,consider Koch's and send pleural fluid for ADA,,,staining and cell count

rt.pleural effusion possibility of pul. Koch's do diagnostic tap & evaluate

rt pluralar effusion .. do tapping send for ada and malignancy....

No... This is case of pneumonia

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