Fig. 15

Tubercular Infection. A 13-year-old HIV-positive male presented with cough and fever for 3 weeks. CXR (PA view) reveals right lower zone haze and bilateral central peribronchial thickening and bronchiectatic changes (A). Axial CECT chest (lung window) shows patchy areas of GGO involving bilateral lungs, centrilobular nodules in right lung (black arrows, B), and centrilobular nodules arranged in typical tree-in-bud appearance in left lower lobe (white arrow, B). Central cylindrical bronchiectasis with peribronchial thickening is also seen. The main pulmonary artery (arrowhead, C) is prominent as compared to ascending aorta suggesting pulmonary hypertension. Conglomerate mediastinal and hilar lymphadenopathy (with some of the nodes showing central necrosis) is also seen (arrows in C,D). CD4 count was 285 cells/cu.mm. BAL/sputum could not isolate any microorganism. ATT was started and the patient improved thereafter clinically