ZARIA THORACIC CLUB MEETING AHMADU BELLO UNIVERSITY TEACHING HOSPITAL,ZARIA,NIGERIA CASE PRESENTATION: DESTROYED LEFT LUNG

CASE REPORT Hassan Umar 38yr soldier Referred from Barau Dikko based on CXR findings. PC -Recurrent cough x12yr -Haemoptysis x12yr -weight loss x12yr -dyspnoea x3yr

Cough-distressing, non paroxysmal, -greenish, mucoid sputum,50ml/day -not posture related Associated with – -scanty haemoptysis -low grade fever -night sweat -weight loss -+v contact with PTB pt -retrosternal dull ache Dyspnoea-progressive No prior hx of trauma to the chest.

Systemic review -not contributory -no jaundice or bone pain Past medical Hx -Diagnosed to have PTB -+v sputum AFB -Had full 9/12 course of Anti TB -4 other episodes over 12yr despite adequate treatment -completed last therapy 6/12 ago. Not a known Diabetic or Hypertensive pt. FSHx

General physical examination. Chest-RR-36/min SPO2 97% -decreased Lt chest expansion -decreased Lt tactile fremitus -dull Lt PN, hyper resonant Rt PN, decreased Lt BS multiple amphoric BS. -Rt BBS, wide spread expiratory rhonchi. Other Systemic Review-

Available invx result- CXR-(7/09/09)-crowded Lt upper rib. -multiple thin walled lucencies Lt lung field. -Patchy opacity Lt lung -hyper inflated Rt lung field. -mediastinal shift to the Lt. -depressed Rt diaphragm.

Sputum AFB- -ve ESR-60mm/hr PCV-43% WBC-5.3,L-30.8%,N-55.2% P-206 x 10

Assessment- Lt Destroyed Lung Syndrome Secondary to PTB - super impossed Bacterial infection R/oMulti Drug Resistant cavitatory PTB