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Question

Hi, I have a 10 years old female patient,from a migrant family of UP with poor S.E, status and a F.H of Kochs. She c/o persistant cough,L.G.F. and pain left lower chest > on deep inspiration. Mx was positive, ESR 78,TLC 5,800 with lymphocytosis. Xray chest suggestive of Rt. lower zone Pleural thickening,hilar shadows prominant and Ultra sound showed a pocket of encysted Pleural Effusion which was tried to be aspirated with a U/S guided needle but the tap failed. Pt.received ATT -PZM,Rifa,INH,Ethambutol for 2months but the encysted Effusion did not get reabsorbed,although the consolidation resolved. ATT was continued for 6months(PZ was stopped after 2months). AS the P.E. persisted a 6weeks course of Prednisolone,Ofloxacin and 60 shots of STM also given.A CTS at the end of 9 months Rx still shows a very small pocket of encysted fluid. 1. Should ATT be discontinued or be given for somemore time? 2. Any need for a surgical intervention? Apparently the child seems to be fully cured. Dr. J.S. Chugh Consultant Pediatrician, S.N.S. Pahwa Hospital,Ludhiana

Answer

ATT may be continued for some more time. Get the HIV tested.
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