Concluded Case

Tubercular plural effusion

62 y/f, Diagnosed as tubercular plural effusion, with severe iron deficiency anemia, treated accordingly, plural tapping done (300ml)2unit blood transfusion, Antibiotics (meropenam )& other supportive treatment.. ATT started on the basis of plural fluid reports.. Now pt c/O pain rt side chest (effusion side)... Today's xray shows consolidation also... What else to do... Again antibiotics /tapping? Plz give Yr valuable opinion.. 🙏

1 Like

LikeAnswersShare
Concluded answer

Pleural effusion rt side consistent with investigations it is tubercular Post tapping pleural thickening is seen in xray chest so it is pleurodynea on rt side Carry on ATT Add prophylactic antibiotic for short period as likely secondary infection Rest of treatment to be continued

All Answers

Pleural effusion rt side consistent with investigations it is tubercular Post tapping pleural thickening is seen in xray chest so it is pleurodynea on rt side Carry on ATT Add prophylactic antibiotic for short period as likely secondary infection Rest of treatment to be continued

Thanx dr Ashok Leel
0

View 2 other replies

The new NTEP guidelines suggest that each and every patient of TB should get CBNAAT done in order to detect the drug resistance. Sir I would suggest that you send the pleural fluid for CBNAAT and treat the patient accordingly if found to be drug resistant. Secondly, as per the patients complain of chest pain, it’s looks a syn-pneumonic effusion which is the cause of pain and there’s not much we can do about it other than treating the cause ie TB. And the anemia could have been anemia of chronic illness and not iron deficiency anemia.

Thank you doctor
0

Pleural effusion ( Tubercular ) to be tapped and sent for analysis and culture. Continue treatment but evaluation For RT -PCR under present circumstances and protocols of covid ruled out. Look for resistant TB.

Thanks Dr Shivraj Agarwal
0

View 1 other reply

Pleural fluid analysis for tuberculosis culture is very important because now a days drug resistant tuberculosis cases are on rise

Thank you doctor
0

View 1 other reply

Lymphocytic predominance and high ADA levl. So consider AKT.

Thank you doctor
0

This is a clearcut case Plueral effusion, Tubercular Continue ATT May consider short course steroids

Thank you doctor
0

62/F..case of unilateral pleural effusion. exudative pleural effusion. High ADA-Mononuclear leukocytosis-hyperproteinaemia suggestive of tuberculous effusion. only to confirm with mycobacterial growth either thru culture or CBNAAT TEST. consolidation patch at lower zone suggestive of active kochs. go for HRCT sos BAL to rule out other infections of any viral origin. Do RT PCR for covid 19. sos pleural effusion cytology test. only in above test LDH is missed. Mostly post primary tuberculosis presents pleural effusion in rare cases seen in primary tuberculosis pleurisy. continue ATT with second line drugs regimen too. for how many months ATT given with dosage.. do repeat cbc-Sr uric acid-LFT-Sr creat-crp-Sr LDH

Thank you doctor
0

NEED'S .. CLINICOPATHOLOGICAL EVALUATION WITH .. CTCE STUDY ..

Thank you doctor
0

View 1 other reply

I think without demonstration of tubercular bacilli , we can't confirm it as a case of tb pleural effusion. Although the ADA level is high. Pleural fluid has very high level of lymphocytes, increased protein level telling us towards the tb pleural effusion, but sugar level is not low. These things making little bit confusion. Still I think you should continue ATT treatment and give some oral analgesic like Tramadol for chest pain. Can do a CECT , rule out diabetes, HIV etc also. Thank you.

Thank you doctor
0

Pleural effusion rt.side ( ? Encysted).Tubercular.

Cases that would interest you