Pulmonary tuberculosis

In this x-ray, there is bilateral patchy shadowing with cavitation, which is particularly prominent in the left upper zone. The patient was a homeless male who presented with marked weight loss, fever and sweats. His sputum was positive for acid-fast bacilli (AFBs), and subsequent culture demonstrated Mycobacterium tuberculosis. This chest x-ray is typical of post-primary disease. Note the absence of hilar enlargement. Although this radiological pattern is characteristic in HIV-negative patients, it is important to consider HIV co-infection.