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Question:
*Tanvi Meha, **Anshul Raja, ***Arbind Kumar Sinha
*Department of Pediatrics, Patna Medical College & Hospital, Patna, Bihar, **Department of Radiodiagnosis, Era’s Lucknow Medical College & Hospital, Lucknow, Uttar Pradesh, *** Department of Physiology, Anugrah Narayan Magadh Medical College & Hospital, Gaya, Bihar

Address for Correspondence: Dr. Tanvi Meha, 403, Jaya Neelam Vihar, IAS Colony, Patna, Bihar, India. E-mail id: tanvimeha@yahoo.com

A 3.5 years old female child presented to pediatric outpatient department (OPD) with fever for seven days. She was on anti-tuberculous therapy (ATT) for the past 2 years when she had an episode of cough and respiratory distress. She was diagnosed to have tuberculosis (TB) on the basis of her chest x-ray by a physician. Since her chest x-ray did not improve after six months of ATT regime, the physician referred her to another doctor. She was asymptomatic at that time and the next doctor asked her to continue with the same treatment regimen. Her serial chest x-rays continued to show persistence of the abnormality and so she was referred from one doctor to another. When she reported to our OPD, she was still on ATT. On examination, she had decreased breath sounds in left infra-mammary and infrascapular regions. A gurgling sound was also appreciable. Other systems were normal. Investigations showed hemoglobin 11.3 gm%, white cell count of 14,900/cumm, erythrocyte sedimentation rate (ESR) of 34 mm at end of 1 hour. Renal and liver function tests were normal. HIV Elisa and Mantoux test were negative. Her CT chest is depicted in Figure 1.

Is this pulmonary TB_?
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