Presentation
Cough.
Patient Data
Age: 30 years
Gender: Female
From the case:
Tuberculosis - Right upper lobe cavitation
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Extensive cavitating nodular opacities in the right upper lobe, with a large cavity measuring 4cm in diameter. There are multiple nodules also seen in the left upper lobe. Wide right paratracheal stripe possibly due to lymphadenopathy.
The appearances are highly suspicious for pulmonary TB.
Case Discussion
The patient went on to have bronchial washings confirming pulmonary tuberculosis.
Microscopy
- Auramine-Rhodamine Stain: +++ (> 10 Acid fast bacilli detected per HPF)
- Ziehl-Neelsen Stain: +++ (> 10 Acid fast bacilli detected per HPF)
Microbiology
- Mycobacterial culture: Mycobacterium tuberculosis = isolated
- M.tuberculosis Complex PCR = detected
- MPT64 Antigen Identification Test: M.tuberculosis Complex = detected
Sensitivities:
- Ethambutol = sensitive
- Isoniazid = sensitive
- Pyrazinamide = sensitive
- Rifampin = sensitive