CASE 1: RIGHT PLEURAL EFFUSION:
47 years old chronic heavy smoker, came with 2 weeks history of right sided chest pain, associated with right top of shoulder pain.
He has no cough, but has slight reduced effort tolerance. He has no fever. Unsure about weight loss history.
Clinically, reduced air entry over right lower zone. Thus, Chest X-ray(PA) was ordered.
PROVISIONAL DIAGNOSIS:
PLEURAL EFFUSION FOR FURTHER INVESTIGATIONS, TRO LUNG CARCINOMA
Update:
At tertiary centre, pleural tapping and drainage was done and he was treated as empyema. He was discharged well and will have further review with the hospital.
CASE 2: RIGHT PLEURAL EFFUSION SECONDARY TO PULMONARY TUBERCULOSIS:
40 years old lady, came to us with cough for 2 weeks, associated with mild fever and shortness of breath.
Her husband is currently under treatment for active pulmonary tuberculosis.
Chest X-ray done showed right pleural effusion. She was then referred to tertiary centre for further management.
Further update from the hospital – patient’s pleural fluid is positive for acid-fast bacilli.
Final Diagnosis: Right Pulmonary Tuberculosis, complicated with Pleural Effusion