Post-tuberculosis (TB) Unilateral Left Lung Damage: TB Misdiagnosis and Mismanagement.

The extent of lung damage post-tuberculosis (TB) infection varies greatly, resulting in impairment of pulmonary structure and/or function. We present a case of TB misdiagnosis and mismanagement in a 53-year-old black African male living with HIV on anti-retroviral therapy (ART) with post-TB unilateral left lung damage. He presented with a one-month history of intermittent symptoms of fever, night sweats, right-sided chest pain, exertion intolerance, and hemoptysis, and was commenced on anti-TB treatment (ATT) at a local clinic despite the two negative TB infection laboratory results. Further evaluation, later by TB specialists, showed an underweight male in no obvious respiratory distress (at the time of examination), normal vitals, positive Trail's sign, chest asymmetry, and a displaced apex beat. Radiological findings included a collapsed left upper lung with extensive fibrosis and mediastinal shift on chest X-ray. Chest CT scan findings revealed bronchiectasis, left lung collapse with left upper lobe cavitary lesion containing an irregular mass, shift of the mediastinum to the left, and compensatory right lung hyperinflation. Laboratory findings showed a normocytic anemia.