Description
A woman aged 48 years presented to the accident and emergency department with three episodes of massive haemoptysis of ~500 mL. On examination, her vitals were stable. She had a history of pulmonary tuberculosis 2 years prior to this episode for which she had taken a complete course of antituberculous drugs for 9 months and was symptom-free and sputum culture-negative at the end of treatment. Her blood routines showed leucocytosis and raised inflammatory markers (ESR). Sputum and bronchoalveolar lavage specimens were smear positive for acid-fast bacilli, thus she was diagnosed to have a relapse with active tuberculosis.
Imaging evaluation included a chest radiograph which showed cavitatory lesions with air fluid levels in bilateral lung fields with surrounding air space shadowing (figure 1). A plain multidetector CT (MDCT) was performed, which revealed multiple discrete cavities randomly distributed throughout both lungs (figure 2) and the largest cavity was...
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