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What are the findings from the chest Xray report? Suggest the required treatment

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General & Family Physician
Practicing since : 2005
Answered : 1766 Questions
Hallo doctor, My mother name is XXXX. She is 64 years old. She has BP and rheumatic arthritis. She is taking a homeopathy treatment for the same and is under control. She has been suffering from a prolonged cough which intensifies during nights. Initially we thought it could be due to climate change however it continued. She was suggested a chest x-ray. The observations of the X-ray report are as follows, "Soft opacities noted in both lower zones...s/o Koch's....please compare the lesion with previous X-ray....Trachea is in centre. Costophrenic angles are clear. Heart size and shape is normal. Bony thorax is normal. No e/o lymphadenopathy noted." Could you please tell us if she has been diagnosed with TB (Tuberculosis) and if so what stage it is at? What further treatment could be taken to ensure its TB. Is it really TB or a different infection. What is the good treatment for TB. Kindly advise. Message from XXXX – 0000 / 0000
Posted Wed, 1 Jan 2014 in Infections
Answered by Dr. T Shobha Deepak 1 hour later
Brief Answer: Sputum examination for AFB Detailed Answer: Namaste Welcome to Healthcare-Magic Greetings of the day Dear Mr XXXXXXX I do understand the concern regarding your mother. The radiological findings could be consistent with pulmonary Oedema, it's more likely keeping the nocturnal occurrence of coughing and also the risk factor of Hypertension. Tuberculosis is unlikely to present with both side affection , that is tuberculosis is unlikely to be bilateral. But it cannot bee ruled out completely. I would suggest you the following investigation 1. Sputum examination for Acid fast bacilli- will demonstrate tuberculosis bacteria, Bactec test can also be done on it 2. ECG AND 2D echocardiography to know if heart disease is the cause of manifestation of disease. I would also like to have a look at the X-ray of the chest to give further personalized opinion about the same. Remember X-ray are just a shadow of real thing and they can be decisive and many findings can be seen in different disorder . it would require clinico radiological correlation. Any chronic cough it's important to rule out the following three condition 1. Tuberculosis 2. Cardiac disorder 3. Gastroesophageal reflux For the time being, symptomatic relief from cough can be achieved by following 1. Steam inhalation 2. Avoiding lying down immediately after food 3. Soothing cough syrup may help Will be happy to assist you further. Take care Best Regards Dr T Shobha Deepak MBBS,MD
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