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.