Progression to MILIARY TUBERCULOSIS in a PTB defaulter.

Radiological progression ..Cxr of June and December. Hrct in December Clinically weight loss ~15KG Loss of appetite Shortness of breath

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Every case of tuberculosis is very important India has set goal of eradication of tuberculosis by 2025 Every case of tuberculosis need to be cured to achieve that goal Proper and in depth counseling in important to ensure compliance of patient in completing antitubercular treatment Next very important question is - Is it drug resistant tuberculosis? In most likely scenario we may not have tubercular culture sensitivity report. It is very important to send Sputum sample for tuberculosis culture before starting in antitubercular treatment. Miliary tuberculosis is known to have Sputum negative for tuberculosis Bronchoalveolar lavage sample may be sent for tuberculosis culture

We have sent for it sir. Will update it
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1st Cxray shows positive meniscus sign sugg of moderate pleural effusion on Rt side. Progressive decrease in further Cxray. Possibly tubercular effusion responded to medical management.

Chest X-RAY show's that, middle and lower lobe of both sides of lungs full heziness. Needs blood and sputum investigation for the findings of Tuberculosis. Suggest HRCT THORAX and CBNAAT and also COVID 19 with RTPCR.

Thank you Sir@Dr. Sandeep Ghodekar .
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TUBERCULOSIS  Dr X-Ray findings are not suggestive of pulmonary TB. Peri hilar prominence seen on a chest x-ray may be due to lymph gland enlargement or prominent broncho-vascular markings.ONLY HILAR GLANDULAR ENLARGEMENT IS SIGNIFICANT.

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