A 10-year-old girl presen...

A 10-year-old girl presented with complaints of shortness of breath, especially on the left side, which had worsened since 2 days before admission. She also exhibited a cough with phlegm and had been experiencing fever for the past 1 month before admission. The patient's uncle, who lived in the same house, had a history of shortness of breath and a prolonged cough. He was diagnosed with pulmonary tuberculosis at the local health center 2 years ago but had incomplete treatment, due to drug withdrawal. Upon physical examination, the patient's respiratory frequency was 40 times per minute, temperature was 37.6 degrees Celsius, and oxygen saturation was 95%. Anthropometric examination revealed underweight and undernourished status with normal stature.  Anemic conjunctiva, subcostal and intercostal retractions, decreased left chest movement, reduced left chest expansion, and greater right tactile fremitus than left were observed. Thoracic percussion revealed faint sounds, and auscultation indicated decreased vesicular sounds and coarse wet rales in the left lung field. Blood tests showed a haemoglobin level of 6.6 g/dL, with other laboratory results within normal limits. The thoracic x-ray revealed left apical bronchopneumonia with left basal pleural effusion. Tuberculosis molecular rapid test results were negative, but the Mantoux test result was positive. Pediatric pulmonary tuberculosis scoring yielded a total score of 6, leading to a diagnosis of pulmonary tuberculosis with sinistra pleural effusion, anaemia, chronic infection, and malnutrition. The patient received oxygenation management with a nasal cannula at 2 litres per minute, a liquid diet via a 6X50ml NGT, children's FDC 1x4 tablets, ethambutol 1x500mg, vitamin B6 1x1 tablet, and prednisone 2-2-3 tablets. A CT scan of the thorax is planned 1 month after the initiation of anti-tuberculosis drugs.