Investigation
A complete blood count showed potassium elevation but no other abnormality. A sputum examination yielded negative results for acid-fast bacilli. A chest x-ray illustrated profuse, multifocal, poorly defined consolidations predominantly localized in the upper and middle lung lobes. Additionally, a ground-glass appearance was observed in the lower lobes, concomitant with tracheal deviation towards the right as shown in the figure. Due to the invasive procedure of High-Resolution Computed Tomography (HRCT) and the financial constraints faced by the patient, he made the decision not to proceed with HRCT and explore alternative diagnostic options that were more affordable and less invasive. Based on the above findings differential diagnosis includes pneumoconiosis, pulmonary tuberculosis, emphysema, sarcoidosis, rheumatoid arthritis, and other interstitial diseases.
The absence of AFB in sputum, -ve for test gen expert and characteristic chest x-rays favor the diagnosis of silicosis. The patient was admitted to the ward, and high-flow oxygen therapy and steroid administration were given. Furthermore, bronchodilators and leukotriene antagonists were employed to relax the airways and reduce inflammation. Two samples of sputum, one from one spot and another from another morning were negative for AFB. The patient was discharged with an improvement in symptoms. The patient could not follow up due to non-compliance.