Thanks for your question on Health Care Magic.
I can understand your situation and problem.
In my opinion, you should get done chest x ray or CT thorax to detect tubercular infiltration.
Your blood report like IgM for TB is positive but
mantoux test is negative. Your sputum for AFB is also negative. So we can not say it is 100%
tuberculosis. You might be having tuberculosis as you are having cough with
hemoptysis.
So further evaluation with chest x ray or CT thorax is needed. Because some radiological findings like upper lobe infiltration, cavitory lesion, tree in bud appearance etc are characteristic of tuberculosis.
So if any of these is present than you may need anti tubercular drugs.
Bronchoscopy with BAL (
bronchoalveolar lavage) analysis is also more informative in diagnosis of tuberculosis.
So better to get done these investigations first to rule out tuberculosis in your case.
Hope I have solved your query.
Wish you good health. Thanks.