Case Presentation

8 year-old girl with chronic cough and recurrent hemoptysis (about 100 cc) since 20 days ago admitted in our hospital.
 

She hadn't fever, weight loss and anorexia.

Past Medical History

She had history of GERD in infancy that was admitted in hospital for 20 days and treated medically.

Vaccination was performed completely.

BCG scar is present.

No history of tuberculosis, in family.

She has four siblings and her birth weight was 2/5 kg.

Physical Examination

Patient was conscious without respiratory distress.

She wasn't ill appearing

She was not hypoxemic or tachypenic.

Percentile of height is 25% and weight 25%.

Multiple lymphadenopathy in anterior cervical region and left supraclavicular region were detected. (0.5×0.5)

Physical Examination

Chest: Heart sounds were normal, in auscultation of lungs diffuse fine crackles were revealed.

Abdomen was normal.

Limbs were normal.( No clubbing)
 

Lab Findings

CBC:

WBC=25000, N=77%, L=17%, M=4%, E=2%

HGB=12

HCT=38

ESR        4        84           111

CRP= +

LDH=252           428

LFT=Normal         U/A=Normal

Immunoglobulins=Normal

Mycobacterial findings

PPD= Negative

Gastric Washing Lavage x 3(AFB)=Negative

Smear and culture of GW for pyogenic

microorganism =Negative

PCR of GW(BK) =Negative
 

Radiological findings

CXR= Mass Consolidation in left parahilar region with adenopathy in same side.

Sinus Xray= Normal

Lung CT-scan= Consolidation in anterior segment of LUL with left parahilar lymphadenopathy and mediastinal calcification.

Abdominal sonography=Normal

        What is the patient's possible diagnosis?