PMC10233338_01
Images illustrating findings of pertinent investigations. (A) Chest X-ray: right lower zone and left retrocardiac opacification (day 1). (B) Chest CT: lung window:multiple nodules (day 2). (C) Intraoperative findings of the left axillary node; note the caseous material (day 4). (D) Tuberculin skin test at 72 h shows a large induration; the inner edges of the lines drawn depict the outer edge of the induration; this measured 26 mm (day 5). (E) Chest CT: lung window:nodule resolution (month 4). (F) Chest CT: mediastinal window:thymic rebound (month 4). (G) Chest CT: lung window:bibasal pneumonia, left > right (month 4). (H) Chest CT: mediastinal window:bibasal pneumonia (month 4).
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Plain chest radiography at admission showed bilateral airspace opacities ( Figure 1A ). Chest computed tomography (CT) revealed multiple bilateral large lung nodules ( Figure 1B ). Left axillary lymph node biopsy macroscopically revealed caseous material ( Figure 1C ). Figure 1D ). First-line anti-tubercular therapy comprising isoniazid, rifampicin, pyrazinamide, and ethambutol was initiated. After 2 months of TB therapy, the follow-up CT chest showed complete resolution of the lung nodules; however, bilateral basal ground glass opacification was noted ( Figures 1E-H ).
Timeline of events. FBC, full blood count; PBF, peripheral blood film; CXR, chest radiograph; CRP, C reactive protein; PCT, procalcitonin; CT, computed tomography; BAL, bronchoalveolar lavage; TB, tuberculosis; RX, treatment; PID, primary immunodeficiency; +, positive.
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