A 40 year old man presented with repeated episodes of bronchospasm and hemoptysis. Chest X-ray revealed perihilar bronchiectasis. Which of the following is the most likely diagnosis?
Patient in the question is showing features of allergic bronchopulmonary aspergillus. It is a hypersensitive disease of the lungs seen in atopic individuals who develop asthma and peripheral blood eosinophilia following inhalation of aspergillus species. Patient presents with fever, cough, malaise, hemoptysis, breathlessness and worsening of asthmatic symptoms. X ray chest shows small, fleeting, unilateral or bilateral infiltrates with ill defined margins and hilar or paratracheal lymph node enlargement, to chronic consolidation and lobar contraction. Ref: Davidson's Principles and Practice of Medicine, 19th Edition, Page 540 ; Fungal Infection:Diagnosis and Management By Malcolm Richardson, 4th Edition, Pages 180-1
Sarcoidosis
Idiopathic pulmonary fibrosis
Extrinsic allergic alveolitis
Bronchopulmonary aspergillosis