What does Koch's in the lungs suggest?

Q: My 26 years old cousin suffered from pulmonary (chest) tuberculosis infection 3 years ago. It was completely cured after the mandatory 6 months treatment. We go to the doctor for follow up every year. The infection was passive i.e. there was no risk of infection to others. In every X-ray report it states that Koch's is observed on left upper side of the lungs. When we consulted the doctor last year, he said that the scars would remain for a long time. Just three days back, we have got his chest X-ray done which states that fibrocalcific opacities are seen on left upper side of the lungs. What do these finding suggest? His weight has also increased after treatment from 74 to 80 kg. Please advise.

A:Pulmonary Koch's is usually treated for six month by anti-tubercular therapy. If the x-ray at the start of treatment has improved and now the x-ray changes are static over the years, as per the radiologist than they most likely represent the scar of the disease. Signs of recurrence are fever, cough with sputum, blood in sputum, weight loss etc. Chest x-ray shows increase in the size of opacity.