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Does my daughter have any lung disorder?

Q: My 11 years old daughter is suffering from right side ribs pain. The x-ray/ultrasound suggests a doubt about fluid filled in between the lungs and its membranes. As per the haemogram test suggested by the physician the result is as under: Differencial % Leukocyte counts; Segmented neutrophils 50%, Lymphocytes 39%, Monocytes 6%, Esinophils 5%, Basophils 0% and Differencial absolute Leukocyte counts; Neutrophils 3.60, Lymphocytes 2.90, Monocytes 0.43, Esinophils 0.36, Basophils 0. The ESR westergren is 57. In the report they highlighted Basophils 0.00 and ESR Westergren 57. Do the results indicate any lungs disease like TB or any infection? Please advise.

A:It is difficult to be certain from the history and reports stated as what might be the underlying problem in your 11-year old daughter. There are of course certain aspects of the history, imaging and blood results, which are not normal (such as history of pain over right rib and shoulder, possible presence of fluid in the pleural cavity, raised ESR). Assuming that these results are true and from good quality assured laboratories there are a number of infectious and non-infectious conditions that could result in the symptoms and signs that you have described. Among the infectious causes although TB or tuberculosis is certainly a possibility, there are other common causes (bacterial, viral, parasitic), which may have very similar clinical manifestations. However, since TB is a common infection in India its possibility needs to be excluded by further examination, and investigations. I would suggest you urgently consult a good paediatrician for further advice regarding diagnosis, and treatment. Please do remember that even if the diagnosis turns out to be TB it is a treatable disease (if medications are taken properly) and the long-term outcome is very good. However, early diagnosis (through relevant laboratory investigations and clinical examination) is important to prevent complications and ensure better outcome. Lastly, other common infections (bacterial/viral/parasitic) and non-infective conditions (such as malnutrition and vitamin deficiency) are also very common in the Indian context, and they may have similar clinical presentations. These conditions are also readily treatable if detected early. The history of two previous surgeries (?) might be significant if it had been done with respect to some chest problems. So, please go to your nearest doctor for the children (paediatrician) at the earliest opportunity. My best wishes for your daughter and your family.

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