There are confluent ill-defined areas of consolidation in the mid- and upper zones of both lungs. Given the appearance and distribution of the changes, pulmonary TB has to be a primary consideration. Altered immunity from HIV should be considered (Table 1.14).
Table 1.14 Chest X-ray manifestations of TB
■ Primary pulmonary TB
• Air space consolidation 1-7 cm diameter
• Lymphadenopathy: hilar, paratracheal
• Pleural effusion
• Segmental consolidation
• Calcified ghon focus
• Calcified lymph nodes
■ Post-primary TB (reactivation or initial infection or infection post-BCG)
• Apical and posterior segments of upper lobes
• Chronic patchy ill-defined areas of opacification
• Cavitation may colonise with Aspergillus
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