Monday, May 29, 2017

A 45 years old patient presents with history of cough and expectoration for several months....

A 45 years old patient presents with history of cough and expectoration for several months. His chest X ray is shown below:

Describe the findings on the X ray and what could be the diagnosis?

Radiological Findings And Explanation
X-ray chest shows that the lungs are large in volume with streaky shadows and multiple cystic lesions with air fluid levels. These cystic lesions can also be seen through the heart shadow. This is most probably a case of bronchiectasis.

Bronchiectasis is localized, irreversible dilation of part of the bronchial tree as a result of destruction of the muscle and elastic tissue of bronchial wall. Involved bronchi are dilated, inflamed, and collapsible. They result in airflow obstruction and lead to impaired clearance of secretions which
on X-ray is seen as air fluid levels

Diagnosis: Bronchiectasis

Clinical Discussion:
Bronchiectasis results from necrotizing bacterial infections, caused by the Staphylococcus or Klebsiella species or Bordetella pertussis.
The diagnosis of bronchiectasis is based on the review of clinical history, X-ray chest and CT scan show characteristic patterns.
Bronchiectasis is often caused by recurrent inflammation or infection of the airways. Most often it begins in childhood as a complication from infection.
Tuberculosis is the leading cause of bronchiectasis. Endobronchial tuberculosis commonly leads to bronchiectasis, from bronchial stenosis or fibrosis. Acquired Immune Deficiency Syndrome (AIDS) is another major cause especially in children.

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