CXR Case 046
A 25 year old female presents with dyspnoea, cough, fevers and sweats
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There are small rounded opacities of variable size throughout both lung fields, more dense on the right.
The right heart border is lost, suggesting middle lobe involvement.
This is miliary tuberculosis (TB).
She is likely to be coughing mycobacterium around your department and needs to be isolated.
Sputum should be sent for urgent Ziehl–Neelsen acid fast bacilli stain.
HIV test is mandatory.
Early genomic testing can indicate risk of multi-resistant TB – which is prevalent in eastern Europe.
Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar | ICIS Course ANZ