BMJ Case Reports 2012; doi:10.1136/bcr.01.2012.5498
  • Unusual presentation of more common disease/injury

Tuberculous mediastinal abscess as a paradoxical reaction in an immunocompetent individual

  1. Lorraine Simone Dias4
  1. 1Department of Medicine, Kasturba Medical College, Manipal, Karnataka, India
  2. 2Department of Cardiology, Kasturba Medical College, Manipal, Karnataka, India
  3. 3Department of Radiology, Kasturba Medical College, Manipal, Karnataka, India
  4. 4Department of Internal medicine, Kasturba Medical College, Manipal, Karnataka, India
  1. Correspondence to Dr G Vivek, vivekgraman{at}


A 22-year-old man, diagnosed 7 weeks before with pulmonary tuberculosis and started on antitubercular therapy, presented with non-exertional retrosternal chest pain since the past week. He was diagnosed on the strength of thoracic radiograms and CT imaging to have a mediastinal abscess, which was percutaneously drained. He was continued on the same regimen of drugs. Analysis of the fluid obtained was suggestive of tuberculous aetiology. Steroids were not required.


  • Competing interests None.

  • Patient consent Obtained.

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