Presentation
Afebrile shortness of breath with weight loss.
Patient Data
Cavitation, alveolar consolidation, and severe bronchiectasis are noted predominantly in the upper lobe of the left lung. Endobronchial spread along airways with a tree-in-bud pattern. There is also mediastinal lymphadenopathy.
Case Discussion
Post-primary pulmonary tuberculosis, also referred to as reactivation or secondary tuberculosis, typically manifests years later, often in the context of compromised immune function. The predominant sites for the development of post-primary TB within the lungs are posterior segments of the upper lobe and superior segments of the lower lobes.
In comparison to primary infections, post-primary infections have a higher propensity to cavitate. Endobronchial spread along adjacent airways observed frequently with "tree-in-bud" sign.
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