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Chest x-ray showed suspicious infiltrates in the left upper lobe. Should I consult doctor?

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I had a routine chest x-ray and results read as follows: "There are suspicious infiltrates in the left upper lobe. The rest of the lungs are clear. The hila and pulmonary vessels are within normal limits. The heart is normal in size and configuration. Mediastinum and diaphragm are normal. The visualized bones are unremarkable. The soft tissues do not appear unusual. Spot film of the left upper lobe is suggested XXXXXXX
I then proceeded to have a chest spot view of the left upper lung and results read as follows: "Previous study done October 23, 2012 reviewed. There are reticular infiltrates seen in the left upper lobe with nodular component due to pulmonary tuberculosis of undetermined activity XXXXXXX
FYI, I do not have any symptoms and in fact feel I'm in the peak of health. For whatever it's worth, I remember my mother telling me that I had primary complex as in infant. I am leaving for a 3-week trip in 2 weeks' time. I need to know if seeing my doctor can wait until after I get back. I also need to know if what I may have could be contagious.
Thanks a million, Doc! XXXXXXX

Posted Tue, 13 Nov 2012 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 26 minutes later
Hi,
Thanks for posting the query on XXXXXXX
After going through the query, I would like to comment the following:

1. Left upper lobe infiltrates were seen on your routine chest xray.
2. Do you have any slightest of cough, breathlessness or fever?
3. In absence of any symptoms the investigations suggested are a repeat chest xray pa view with proper centralization. Blood investigations - CBC, peripheral smear, mantoux test, ESR, HIV testing.
4. If a repeat chest xray also shows the same findings then a ct thorax may have to be done to rule out any fresh disease activity.
5. In absence of any symptoms you need not worry.
6. However it is advisable that you visit a Pulmonologist and get yourself evaluated as mentioned above.


I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB

Above answer was peer-reviewed by
 
Follow-up: Chest x-ray showed suspicious infiltrates in the left upper lobe. Should I consult doctor? 21 minutes later
Dear Dr. XXXXXXX

Thank you for your reply. To answer your question (#2), I do not have the slightest of coughs, breathlessness or fever. As I said, right now I feel I'm at the peak of health.

You suggest a repeat x-ray but my first x-ray was already pa view. A repeat after 4 or 5 days will yield the same results, right? Besides it was that x-ray that prompted a recommendation for a spot view of the left upper lung.

Since you say that the absence of any symptoms is no cause for worry, is it safe to assume that I can go ahead with my trip and see the doctor who prescribed the routine chest x-ray (along with other routine tests) when I get back in December (as scheduled)? Is it also safe to assume that I am not going to contaminate anyone with anything?

And if there is nothing to worry about, then why did the 2nd x-ray mention "reticular infiltrates seen in the upper left lobe with nodular component due to pulmonary tuberculosis of undetermined activity"? What exactly does that mean? Could my primary complex in infancy have anything to do with this?

I hope you can give me a clearer answer so I know if this is something that can wait or needs to be attended to immediately.

Thanks.
 
 
Answered by Dr. Gyanshankar Mishra 6 hours later
Hi,
Thanks for the follow up query. After going through the follow up query, I would like to comment the following:

1. Since you do not have any symptoms such a lesion can be a fibrotic lesion as a result of childhood infection. Sometimes xray rotation gives rise to such shadows. A ct thorax will give a clearer picture. It only takes 1 day to get a hrct thorax done. So you can do a hrct thorax before your trip and the lesion if any can be detected and diagnosed.

2. Since you are asymptomatic , the chances of you being infective are quiet less. Other investigations as advised above will lead us to the cause if any of the shadows.

3. Thus atleast a hrct scan thorax and pulmonologist consultation with the report prior to you planned visit is recommended.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
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