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Dr. Andrew Rynne

Family Physician

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What does this lung CT scan report indicate?

Answered by
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Dr. Jnikolla

Pulmonologist

Practicing since :2003

Answered : 1391 Questions

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Posted on Wed, 23 May 2018 in Lung and Chest disorders
Question: Hi,
I have previously asked Dr. Jnikolla regarding my lung CT scan. It was thought at the time to be possibly TB or some form of pneumonia. However, the latest opinion is that it is either a recent or old lung infection.
I have reproduced the CT report and attached images from the scan and would seek your opinion.


Thankyou.


There is a cluster of ill-defined nodules in the apical segment of the left lower lobe. There is no evidence of cavitation or calcification. The rest of the lungs are clear. There is no pulmonary consolidation, pneumothorax or pleural effusion.

The airways are patent. Incidental note of the posterior segmental bronchus of the right upper lobe, arising directly from right bronchus intermedius.

There is no mediastinal, hilar or axillary lymphadenopathy. The heart size is within normal limits. There is no pericardial effusion. The visualised upper abdomen is unremarkable.

No rib fracture, rib lesion or chest wall abnormality is detected. No significant bony abnormality is detected.

IMPRESSION

The cluster of ill-defined modules in the apical segment of the left upper lobe is likely inflammatory/infectious. Specifically, TB should be considered.

There is no cavitation or lymphadenopathy.
doctor
Answered by Dr. Jnikolla 1 hour later
Brief Answer:
probably pneumonia

Detailed Answer:
Hello

I am glad to hear from you again.

I evaluated very carefully the chest CT you have attached.

Regarding the images in my opinion and with my experience if the PPD test and Quantiferon B is negative for AFB (tuberculosis) than this is mostly a pneumonia that needs treatment with antibiotics (such as Claritromycin orally for 7-10 days)

After three months (not earlier) usually we recommend a repeated chest CT for follow-up of the Ct finding.

There is not any other test or examination that is definitely exact in the diagnosis except the biopsy but i don't think this is your case.

Please discuss with your doctor for the above

Hope to have been helpful for you

Regards and feel free to ask me again

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Jnikolla 21 hours later
Thanks Dr. Jnikolla,

At the time of having the cough recently, I did a blood test (attached) which showed the infection was likely viral since the immune response wasn’t elevated enough.

Should I continue to just wait for the infection to clear if still present or is it likely that the CT indicates perhaps a past bacterial infection leading to some scarring?


Thankyou.
doctor
Answered by Dr. Jnikolla 51 minutes later
Brief Answer:
continue discussion

Detailed Answer:
Hi again

CRP 19 is high and it is indicative of infection and antibiotics would be needed (for example Claritromycini orally twice)

So in my opinion the chest CT finding is mostly of inflammatory origin (bacterial or even viral) do not worry.

If even after the treatment and CRP normal the image is still there probably some scarring might be in it.

However the follow up CT should be done absolutely to be sure.

Regards

Dr.Jolanda


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Jnikolla 2 days later
Thanks Dr. Jnikolla,

I understand that the crp usually would be higher in the case of bacterial as opposed to viral infection but it’s not a very reliable indicator of infection type.

As my crp has returned to normal, perhaps as a precaution I could take an antibiotic which does not interfere with possible TB culture of the sputum. Would there a good type of non-penicillin antibiotic for this purpose?


Thankyou.
doctor
Answered by Dr. Jnikolla 6 hours later
Brief Answer:
continue discussion

Detailed Answer:
Hi again

Yes you can take Azithromycin tab orally once for 3-5 days.

Regards

Dr.Jolanda


Above answer was peer-reviewed by : Dr. Kampana
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