Post-primary tuberculosis

Case contributed by Dr Pawel Piotrowicz

Presentation

Non-specific cough for last three months. Good social status. Contact with tuberculosis not reported.

Patient Data

Age: 20 years
Gender: Female
X-ray

Diffuse reticular and micronodular pattern with a predilection for upper and middle zones. There is a mass in the middle zone of the right lung and two cavities in the middle and upper zones of the left lung.

CT

Areas of micronodular pattern in upper lobes and apical segment of lower lobes and middle lobe, with tree in bud sign. 

There are also areas of consolidation with cavitation located bilaterally in segments 3, and in segment 1/2, segment 2R and segment 6R. 

No pleural effusion. No significant mediastinal lymphadenopathy.

Case Discussion

Although tuberculosis is mainly a problem in developing countries, there is a rising incidence in developed countries too. Therefore it is important to use chest x-ray as a relatively low dose clinical test which returns valuable results, especially in younger patients with uncertain airway changes. In this case bronchial lavage smear for acid-fast bacilli was positive, CT was performed to exclude other thoracic pathologies.

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Case information

rID: 52295
Case created: 1st Apr 2017
Last edited: 10th May 2017
System: Chest
Inclusion in quiz mode: Included

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