Identifying tuberculosis from Pneumoniae
Tuberculosis also presents with consolidations, which may be lobar or..
Tuberculosis also presents with consolidations, which may be lobar or patchy consolidation, but when the history is long-standing and you see consolidation with long-standing fever, night sweats, and chronic cough, then you should suspect tuberculosis.
Besides this, there are certain imaging features which point to the possibility of tuberculosis-
a. Presence of Lymphadenopathy along with consolidation:
The presence of consolidation in right middle zone which is limited by horizontal fissure inferiorly ( sharp demarcation); along with hilar nodule ( red arrow), suggest for Primary TB in a young patient.
b. Scattered pulmonary opacities and nodules:
Scattered pulmonary opacities and nodules in the right lung, and some coalescing nodules forming larger nodules in the left lung. These nodules are asymmetric on the right side, and coalescing in nature, pointing to the infective nature of the nodules.
c. Presence of upper lobe/apical predilection .
Can be appreciated in both the Xrays given above.
d. Presence of cavity of an intermediate smooth wall.
In this Xray, we can see scattered nodules in both lungs, along with the presence of an apical cavity in right lung.
e. Presence of miliary opacities.
Note the presence of tiny 2-3 mm sized discrete opacities in both lungs, which are miliary opacities.