Post-primary pulmonary tuberculosis

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Weight loss, cough, hemoptysis.

Patient Data

Age: 50 years
Gender: Male

Bilateral apical pulmonary cavities, better seen on the left. Patchy left upper zone consolidation. No pleural effusion. 

Bilateral apical pulmonary cavities. Bronchiectasis with bronchial wall thickening. Extensive tree-in-bud opacity with further areas of focal consolidation. Enlarged right hilar node. 

Case Discussion

The imaging of this case is typical for post-primary pulmonary tuberculosis with cavities, endobronchial thickening and tree-in-bud opacity. The patient proceeded to bronchoscopy: 

Mycobacterial investigations

Specimen Type: Sputum 

Microscopy: Auramine-Rhodamine Stain: +++ (> 10 Acid fast bacilli DETECTED per HPF) 

DNA Amplification Assay for M. tuberculosis Complex (PCR): DETECTED

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