A 19-year-old woman was referred to our hospital with complaints of productive cough and massive hemoptysis. One month earlier she had been admitted to a hospital in the northern province of the country with symptoms of fever, weight loss, and bloody sputum. A computed tomography (CT) scan was performed and showed cavitary lesions with nodules in both lungs. Medical therapy for pulmonary infection consisting clindamycin and ceftriaxone was started, but did not respond well to the treatment after 3 weeks. So bronchoscopy was performed which reported an acute severe bronchitis. Culture of bronchoalveolar lavage specimen was negative after a 7-day inoculation and the transbronchial lung biopsy (TBLB) showed pulmonary angiitis granulomatosis compatible with Wegener's granulomatosis. Also antinuclear antibody test (ANA) was positive (1/640) but anti-dsDNA was negative. She was referred to our hospital for a complementary workup.