Well, I thought this patient would have active TB. 3 AFB's were negative. Here is a CT we then got:
We bronched her and all AFB's are still negative, 6 days later. The TBBX was also negative:
minimal inflammatory cells. Bronchial mucosa and submucosal glands are unremarkable. Alveoli show few pigment laden macrophages. No evidence of granulomas or viral inclusions is seen. AFB stain is ordered, see addendum.
She is currently taking 4 drug TB therapy (after bronch)
What would you do now??