Concluded Case

Squamous cell carcinoma with METs ...

Male 67 years presented with cough, dyspnea, discomfort and weakness. Had fever before 8 days.. had headache off and on. COVID negative. Developed respiratory distress with tachycardia... CT scan of brain and chest as under. Hemodynaemically stable, Spo2: ~90%.... what is line of treatment?

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Concluded answer

Squamous cell carcinoma confirmed on Biopsy...

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B/L Pulmonary Nodules with mild Cardiomegaly with pericarditis, Ddx, COPD, EMPHYSEMA, PNEUMONIITS, CARDIOMEGALY, BRONCHITIS, DO CBC & ESR, 2 D ECHO, USG CHEST, RT PCR DUE TO COVID -19, Serum ADA, ABG, CBNATT, ECG, D-DIMMER, GIVE HIGH FREQUENCY OXYGEN THERAPY (HFOT) WITH NON INVANSIVE SUPPORT, (NIVBP), and strong antibiotics with supportive and symptomatic support.

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Ct brain shows hypodense lesion rt parietal lobe near inferior horn of ventricle with generalised cerebral oedema Hrct shows cavitory lesion in rt infrahilar mid zone on rt side with tree in bud sign Pt has sp02 90% and hemodynamically stable You have r/o covid19 Dysponea with cough and fever and weakness with tachycardia are likely due cerebral pathology which is likely tuberculoma interpreting in conjuction with chest pathology which is tuberculosis Still my impression is pt may be covid positive hence adv to repeat rt pcr

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Dr gauruv plz see film no 3 and film no 8,in addition to right parietal love lesion and vasogenic oedema there is also involvement of brainstorm on left side specially. Miliary involvement of lung. Miliary involvement of lung means ,TB ,dissementated infection or metastasis. Multiple level brain involvement and miliary involvement of lung pin point to metastatic brain and pulmonary disease. Patient is critical because his brainstorm breathing area is being caught. Prepare for icu. He will be compromised in next 72 hours

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Ct chest shows old etiology with b/l pulmonary nodules with cardiomegaly See for Chest xray See for abg See for other blood report with esr Thyroid profile See for ecg Give patient oxygen support Ct brain wnl Treat patient as covid protocol Send swabs after 3 to 5 days when it came negative to rule out covid And treat accordingly

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Pulm koch,s and inflammatory granulomas with perifocal oedema

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Both pulmonary and cerebral lesions. DD 1) PT with multiple tuberculoma brain with surrounding edema ,? Miluary TB ,? HIV + 2) PT with Neurocysticercosis 3) COVID infection Needs stabilization, investigations

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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!

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Rt mid zone haziness Tree in bud appearance Cerbral thrombosis Cbnat opinion of Neurologist chest physician 2 decho lipid profile t3 t4 tsh

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Fibrocavitatory disease of chest Multiple ganulomas with perilesional oedema Brain Cause ? Tubercular

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Pulmonary tuberculosis with pneumonitis Cerebral tubercolomas RT PCR for covid to be repeated again

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