case_images: PMC10071913_01
case_images: Chest X-ray (PA view) showing cavity in right upper and lower zone (a), CT-Thorax showing thick-walled cavity in right lower lobe (c); Pure Tone audiogram (d) mild sensorineural hearing loss (SNHL) in right ear and severe mixed hearing loss with profound loss at high frequency in left ear, and (b) showing response to treatment
case_images: JFMPC-12-181-g001.jpg
case_images: PMC10071913_01_JFMPC-12-181-g001.jpg
case_images: jfmpc_1415_22-f001
case_images: Chest radiographs demonstrated a cavity in the right upper and lower zone [Figure 1a]. CT scan of the thorax [Figure 1c] revealed a cavity measuring 4 x 3 cm with a few nodules in the right upper lobe and a cavity measuring 5 x 2 cm in the right lower lobe with normal surrounding lung parenchyma. A pure tone audiogram (PTA) was done which revealed mild sensorineural hearing loss (SNHL) in the right ear and severe mixed hearing loss with profound loss at high frequency in the left ear [Figure 1d]. Follow-up chest X-ray showed significant improvement after 2 months [Figure 1b].
case_images: PMC10071913_02
case_images: Chest Radiograph (PA view) showing multiple cavitary nodules involving bilateral mid and lower zone (a), CT-Thorax showing multiple cavitary nodules with left sided pleural effusion (b), and (c) shows resolution of cavities and pleural effusion after 3 months of treatment initiation
case_images: JFMPC-12-181-g002.jpg
case_images: PMC10071913_02_JFMPC-12-181-g002.jpg
case_images: jfmpc_1415_22-f002
case_images: Chest radiograph (PA view) revealed multiple nodular lesions in both lung fields with left-sided pleural effusion [Figure 2a]. CBNAAT were negative. CT thorax revealed a large rounded mass lesion involving the apico-posterior segment of the right upper lobe, multiple nodular and cavitary lesions in bilateral lung fields, and left sided pleural effusion [Figure 2b]. She is in remission [Figure 2c] until the last follow-up with low-dose glucocorticoids and cyclophosphamide.
case_images: PMC10071913_03
case_images: Chest Radiograph (PA view) showing bilateral cavitary nodules with left sided effusion (a) and CT brain (b) shows features of CSOM (White arrow denoting hypopneumatisation of the mastoid air cells)
case_images: JFMPC-12-181-g003.jpg
case_images: PMC10071913_03_JFMPC-12-181-g003.jpg
case_images: jfmpc_1415_22-f003
case_images: Chest radiograph showed multiple bilateral nodular shadows with left pleural effusion [Figure 3a]. CT brain revealed bilateral CSOM [Figure 3b], and CT thorax showed multiple nodular opacities with few cavitations in both lungs.