Concluded Case

pulmonary tuberculosis

72Y/M with 1 month H/o fever, cough with white sputum, weight loss. Diagnose the CXR

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Concluded answer

Left sided upper zone fibro - cavitatory shadow. Assess the activity of the disease by sending two sputum specimens on different days for AFB smear & bactec culture. Antibiotics may be given intially but please avoid fluroquinolones like levofloxacin to avoid development of drug resistance TB

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consolidation of lower lobes of both lung. may be h/o untreated pneumonia. or hypostatic pneumonia. thanks

Pulmonary tuberculosis

CxR PA A view shows B/L fibrocavitatory PTB.Adv Sputum for AFB/CBNAAT/CBC/HB/ESR& other routine tests to arrive at a Diagnosis....

P Koch's , sputum test for AFB. PPD, Heamogram ESR. ATT as schedule of RNTCP. Tab Levofaxacin 500 OD for 14 days. Tab Paracetamol SOS Tab Multivitamins OD Tab Montelakast OD. for 14days. Complete bed rest with healthy diet. mask on face & separation from family TB is curable so assurance.

no levofloxacin
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Left sided upper zone fibro - cavitatory shadow. Assess the activity of the disease by sending two sputum specimens on different days for AFB smear & bactec culture. Antibiotics may be given intially but please avoid fluroquinolones like levofloxacin to avoid development of drug resistance TB

Yes I do agree with U sir as Levofloxacin if given initially can lead to MDRTB
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non- homogeneous opacities in left upper and mid zones... possibility of tuberculosis.. sputum for AFB,gram staining, culture

h/o smoking. ? occupation. ? I think malignancy also needs consideration Also HRCT lung should be done

Old k chest with secondary infection Less likely relapse in 72 year age Advise - cbc, sputum afb, And never use levoflox...

left upper lobe fibrocavity with second ary infection. Rule out reactivation of pulmonary Koch's, recent infection or MDR tb or atypical mycobacteria. Also diabetes status is important.

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