Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX, Thanks for writing in to us. I have read through your query in detail. In India, any lung abnormality in the upper zones is mentioned as probable TB in chest X ray reports. It is important for the clinician to rule out the possibility of TB especially if the patient has possible TB symptoms like cough for more than two months, weight loss, decreased appetite, low grade continuous fever and enlarged lymph nodes. TB is a disease that can affect any part of the body but commonly seen involving the lungs. Any active TB diagnosis on chest x ray is made only if it is confirmed by additional tests which includes sputum tests, PCR tests etc. Since you have written about interstitial lung disease diagnosed earlier, I suppose it was through X rays and CT scan, it would be important to compare the old x ray (done at least 6 months back) with the present one. If the abnormality in right upper zone shows no changes then it is unlikely to be active TB radiologically. After seeing the enclosed reports, there is raised ESR which is not a disease specific test but just indicates that there may be some problem in the body. The Mantoux test is one of the basic tests for TB reaction and it is normal for your father in law. TB treatment often continues for 9 months to a year and proper confirmatory diagnosis is essential before putting a patient on TB medications. I suggest you consult a TB and chest disease specialist in any of the well known hospitals in your area and discuss the diagnosis in detail. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek

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