Coarse Crepetations

A 3-year-old girl has fever, cough and respiratory distress since 7-8 days; On examination she has coarse crepetations in right lower zone; On chest x-ray there is consolidation seen in right lower lobe; She improved with antibiotics but on follow up at 6-8 weeks she was again found to have increasing consolidation in right lower lobe; The next investigation for her further evaluation should be which of the following? 

A. Bronchoscopy
B. Bacterial culture of the nasopharynx
C. CTscanofthorax
D. Allergen sensitivity test

Ans. C. CTscanofthorax

This child is not likely to have foreign body aspiration as there should be initial air-traping, followed by lung / segmental collapse; This child has recurrent consolidation which needs to rule out underlying predisposing lung pathology like pulmonary sequestration, etc and hence CT scan of chest would be best option for further evaluation; However it should be kept in mind that best investigation before surgery for suspected cases of lung sequestration is angiography;