Delayed presentation of congenital diaphragmatic hernia masquerading as pulmonary tuberculosis in a 4-year-old girl

Diaphragmatic hernias are defined as congenital or acquired defect in the diaphragm. It is said to be the most common intra-thoracic fetal anomaly with an incidence of 1 in 2200 to 3000 live births and male to female ratio of 2:1.The unusual and misleading presentation of this condition which would cause an unnecessary delay in diagnosis and all the attendant consequences (such as intestinal obstruction) is hereby presented. The role of plain chest Xray which is cheap and readily available in salvaging the confusing clinical scenario has been emphasized. Late presenting CDH should be factored in the differential diagnosis of any child with chronic cough. Delay in diagnosis increases chances of complication such as chronic lung diseases and gastro-esophageal reflux, later in adulthood.