A pt of age 50 years came for low-grade fever and mild cough, for three months not responding to treatment. He was treated for a respiratory infection in Jan 2016. He was an alcoholic smoker for whole life, now gave up for three months. His big toe and 2nd, 3rd toe were amputated 20 years back, now he walks with support. At present his CBC is normal, LFT urea creatinine is normal, but ESR is 144, X-ray of Jan and April are attached.
The pt is better with ATT and Thiamine injections. Are his hip joints destroyed due to TB? Or is it because of vascular necrosis as he has Buerger's disease? Gastro scoping show scalloping of the gastric and duodenal mucosa. Sputum has been sent for AFB today only.
