Do TB-negative X-rays in asthma rule out lung complications?

Question

Hello doctor,

My mother has asthma as she used to smoke and live near roads. Her X-ray showed that the trachea is in the midline, the cardiac shadow is not enlarged, the pulmonary vasculatures are not prominent, the hemidiaphragm is flattened, the costophrenic sulci are blunted, right lower lung infiltrates are present, and pneumonia is entertained. Please correlate clinically. Emphysematous changes are also considered.

The last X-ray was negative for tuberculosis. She was using Ventolin as nebulizer three to four months back.

Kindly advise.

Answer 1

Hi,

Welcome to icliniq.com.

I have checked the attached report, along with the data you provided (attachment removed to protect patient identity). Your mother has COPD, which is a chronic obstructive lung disease due to changes in the lungs with age and due to smoking. In COPD, the air is entrapped inside the lung with difficulty getting it out, so the oxygenation is impaired. Thus, the patient becomes hypoxic with frequent exacerbations in winter with any infection of the lungs.

The infiltrates found in the right lung are due to pneumonia. The treatment includes inhalers regularly with antibiotics, and long-term home oxygen therapy may be required if certain criteria are met. To identify the stage, I need to see her oxygen saturation in room air and an arterial blood gas test.

I hope this helps.

Thank you.