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Saturday, 13 September 2014

CASE 275: LUNG MASS, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM



BOY 5 YO   3 DAYS AGO   FEVER AND COUGH.

PEDIATRIC DOCTOR  REQUESTED  BOOD TESTS  FOR  RULE OUT  DENGUE FEVER AND  CHEST  XRAY.
RESULT   RETURNED  QUICKLY (SEE   BLOOD TESTS  AND CHEST XRAY).




DISCUSSION:
FEVER AND RISING OF WBC  WITH  MORE NEUTRO CELLS  ARE  ACUTE
INFECTION, WE CAN RULE OUT  DENGUE FEVER.
BUT THE CHEST X-RAY WAS ABNORMAL, ONE RADIOLOGIST  SUGGESTED  LUNG TUMOR. AND HE  REQUESTED THORAX CT SCAN.



ULTRASOUND  OF  THE CHEST  BY TRANSTHORACIC  DETECTED THIS MASS AT THE LEFT LUNG  WHICH WAS  SOLID  ECHOTRUCTURE  LIKE HEPATIC TISSUE.
IT HAD AIR IN THE MASS AND  VESSELS  WERE NOT BENDING ( SEE ULTRASOUND  IMAGES  WITH  CDI AND VIDEO)
  




Sonologist suggested consolidation pneumonia.
For make sure diagnosis we performed
low dose CT Scan  without CE (see CT pictures).





Radiologist reported that a lobular pneumonia in  consolidation phase of the left lung.
Antiobiotic treatment is in urgency.


After one week treated with antibiotic, the clinical of patient recovered very well. CRP  dropped to 32ng/mL. Chest X-Ray has got near normal status and lung ultrasound  had changed  structure. (See  chest X-Ray and ultrasound pictures of the left lung).



2 comments :

Bs LÝ PHÁI said...

Bệnh nhi 5 tuổi, với bệnh cảnh lâm sàng và hình ảnh XQ và CT Scan như thế, gợi ý đây là trường hợp Abscess phổi giai đoạn đông đặc. Chỉ định kháng sinh tiêm tĩnh mạch.

Anonymous said...

THIS CASE IS ACUTE INFECTION AND OLD ANEMIA
SO THAT WE NEED TO USE EARLY ANTIBIOTIC ( BECAUSE ACUTE INFECTION , I THINK ABCESS IN LEFT LUNG ) .WE DONT FORGET TO FIND CAUSE OLD ANEMIA.