Queridos amigos, hoy os presento las radiografías de un varón de 80 años con fiebre y antecedentes de TB.
¿Cuál sería vuestro diagnóstico?
1. Recidiva TB
2. Empiema necessitatis
3. Neumonía
4. Nada de lo expuesto
Podéis dejar vuestra opinión hasta el viernes, día en que se dará la solución.
Haz click aquí para ver la respuesta
Hallazgos: la radiografía PA de tórax muestra una marcada escoliosis y pérdida de volumen de hemitórax izquierdo, secundario a paquipleuritis tuberculosa calcificada (A, flechas). Tanto en la placa PA como en la lateral se observa un nivel hidroaéreo (A,B flechas rojas). El descubrimiento de aire en enfermedad pleural crónica debe sugerir en primer lugar una fístula bronco-pleural.
El TC axial confirma la calcificación pleural (C, flechas) y el nivel hidroaéreo en la cavidad pleural (C,D flechas rojas).
Diagnóstico final: fístula bronco-pleural por reactivación tuberculosa.
Felicidades al Dr. Gotzon, que hizo el diagnóstico correcto.
Fibrotórax calcificado-Empiema tuberculoso. Parece apreciarse un nivel hidroaéreo, con ese hallazgo y la fiebre, podríamos pensar que esté sobreinfectado pudiendo asociar una fístula broncopleural.
Saludos!
Empiema necessitatis izquierdo. Paquipleuritis. Escoliosis.
Se observa un nivel hidro – aéreo pero en la radiografía lateral no observo comunicación con tejidos blandos. Me quedo con Empiema
Qué tipo de empiema: necessitatis o pleural?
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¡Interesante caso! La fiebre en un paciente con antecedentes de tuberculosis (TB) puede sugerir varias posibilidades. Las radiografías podrían ser clave para llegar a un diagnóstico.
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Queridos amigos, hoy os presento las radiografías de un varón de 80 años con fiebre y antecedentes de TB. En una conversación en Omegle, podríamos discutir el posible diagnóstico y considerar si se trata de una recidiva de TB u otra causa. La colaboración en plataformas como Omegle podría enriquecer nuestro análisis y perspectivas.
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Impresionante análisis, Dr. Pepe. La claridad con la que desglosa cada caso es invaluable para el aprendizaje. Este caso de tórax fue fascinante, y su enfoque diagnóstico siempre inspira. Gracias por compartir su conocimiento de manera tan detallada y profesional.
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It’s fascinating how medical cases can resemble decisions in games like Bitlife, where we navigate life’s challenges. In this scenario, I’d lean towards pneumonia due to the acute symptoms, but a recidiva TB also needs consideration given the patient’s histor
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La edad avanzada y los antecedentes de TB sugieren que una recidiva es una posibilidad importante. La fiebre es un síntoma común en la tuberculosis activa.
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