Mediastinal Tuberculosis Lymphadenitis Complicated with Pulmonary Tuberculosis

Tuberculosis is a growing health problem especially in developing countries. Tuberculosis lymphadenitis is the most frequent occurrence of extrapulmonary tuberculosis. In our case, there was widening of upper mediastinum on chest x-ray and thoracic CT scans demonstrated multilocular abscess on the upper mediastinum which was laying to paratracheal site. Acit-fast bacilli was positive on pus obtained by USG guided fine needle aspiration. Antituberculosis treatment was given. Homogenius infiltration were determined in chest X-ray on the left upper zone 7th day of treatment and fever increased. Although extended spectrum antibiotics treatment were given fever continued and no regression on chest X-ray. Acit-fast bacilli was positive on sputum analysis. We though that mediatinal abcess fistulised to lung parenchima because initial sputum acit-fast bacilli was negative and patient described sputum with pus. Antituberculosis treatment was continued and acit-fast bacilli became negative on sputum.