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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Suspicious Infiltrate On The Upper Lung?

Hi my sister, 25 years old had medical check up and they found fibroinfiltrate on both upper lung and middle left lung from the xray. My sister currently worked at country with high tb for one year. But she didn t have any symptomps when comeback. She went to doctor, check lab and her sputum, the results was high esr, sputum neg, the others normal. The doctor then diagnosed her as tb. I suggest her to do another xray and the result is clear left lung and suspicious infiltrate on upper right lung. She ask me is this really tb but I don t know. Can you help me?
posted on Sun, 8 Jun 2014
Twitter Sat, 15 Nov 2014 Answered on
Twitter Mon, 17 Nov 2014 Last reviewed on
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Pulmonologist,  's  Response
Thanks for your question on HCM.
In my opinion it is PTB (Pulmonary Tuberculosis).
Since TB is airborne infectious disease any one can get the infection from TB patient. And 1 year stay in TB endemic area is sufficient enough to get infection.
Tb bacilli has high affinity for upper and middle lobes as oxygen tension is high in those area and TB Bacilli need oxumygen for growth. So any upper and middle lobe lung lesion should first be investigated for TB.
The tests done for this are
1. Sputum for AFB
2. Bronchoscopy and BAL(Broncho Alveolar Lavage) analysis for TB
3. CT THORAX
So if your sister's sputum report is negative you can still diagnose TB by doing Bronchoscopy with BAL analysis and CT THORAX.
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What Causes Suspicious Infiltrate On The Upper Lung?

Thanks for your question on HCM. In my opinion it is PTB (Pulmonary Tuberculosis). Since TB is airborne infectious disease any one can get the infection from TB patient. And 1 year stay in TB endemic area is sufficient enough to get infection. Tb bacilli has high affinity for upper and middle lobes as oxygen tension is high in those area and TB Bacilli need oxumygen for growth. So any upper and middle lobe lung lesion should first be investigated for TB. The tests done for this are 1. Sputum for AFB 2. Bronchoscopy and BAL(Broncho Alveolar Lavage) analysis for TB 3. CT THORAX So if your sister s sputum report is negative you can still diagnose TB by doing Bronchoscopy with BAL analysis and CT THORAX.