chest x ray - any active TB evidence

Resolved question:

Hi,as a part of routine check up The radiologist my chest x ray report ( PA view )has highlighted the following Slight right apical pleural thickening subtle haze is noted in the right upper lung left hila slightly prominant. i had also got my blood test done which had shown esr = 8 does any of these indicate any eveidence of active TB

Submitted: 4 Days
Category: Sexologist

Expert:  Dr. John Monheit replied 4 Days.

Thank you for consulting with Doctorspring. I understand that you are worried about your X-ray findings and your slightly higher than normal ESR values. TB is a threatening disease especially in terms of lot of Drug resistance problems and rising number of cases due to HIV-AIDS. The diagnosis is not based on a single test or clinical finding. It can be diagnosed only form a combination of clinical features and tests.

Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis. It spreads by air when the bacterium is released into the air by a patient of lung TB. There are two different things to be understood. TB may cause only infection or both disease and infection. In case of infection alone it means that the bacterium has entered the body and multiplied but further multiplication is contained by your immune system. But the bacterium can take advantage of your immune system by multiplying when your body’s defenses are lowered. Risk factors for TB are close contact with an infected person, alcohol dependence, IV drug abuse, cancer, diabetes, prolonged immobilization and HIV-AIDS. The classical symptoms associated with TB are evening rise of temperature, loss of weight, loss of appetite, cough with phlegm and night sweats. If there is involvement of organs other than the lungs, there may be symptoms related to that organ also. Virtually any part of the body may be infected with TB. But, the more commonly involved organs other than the lungs are Bone, Kidney, and Brain.

Diagnosis of TB can be made by a combination of several methods including Chest X ray, Sputum examination and skin tests. Chest X-ray findings suggestive of active TB resemble pneumonia consisting of opacification of one lobe of the lung whereas old healed foci of TB has calcification and fibrosis suggesting that TB has been contained and is inactive. On examination of sputum, TB bacilli are seen with special methods of staining. Usually 3 samples of sputum on separate occasions are taken for examination. Skin tests use a purified bacterial antigen called PPD for determining whether the immune system has been exposed to TB earlier. Newer Interferon based tests are also available. The important thing about skin tests is that they cannot differentiate between infection and disease.

If you have any of the symptoms I mentioned earlier or you are suffering form general ill health, I suggest that you visit your Doctor and show him the X rays and other reports. If necessary, he will be able to direct you to futher tests. Hope this informationwas of use to you. Please use our free follow up question service for more queries in this regard.

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