Mediastinal tuberculosis in a 10-month-old child

We report a rare case of mediastinal tuberculosis in a child who presented as a possible inhaled foreign body. A 10-month-old girl was admitted with a five-month history of cough, wheeze and problematic feeding, thought initi ally to be due to asthma. h clinical deterioration and subsequent X-rays su ggested an inhaled foreign body. However, at direct laryngotracheobronchosc opy no foreign body was found and subsequent investigations revealed a subc arinal mediastinal mass. She underwent a thoracotomy and excision of the ma ss, the histological analysis of which revealed it to be of tuberculous ori gin. When a patient presents with symtoms of upper airway obstruction which are highly suggestive of a foreign body, other causes such as mediastinal tuberculosis must be borne in mind when no foreign body can be found. Altho ugh rare, cases of tuberculosis are apparently increasing and the otolaryng olgoist must be aware of its various manifestations and submit specimens fo r appropriate analysis. We also briefly review mediastinal lymphadenopathy due to tuberculosis.