A 9-year-old girl presented with low-grade fever for 1 month and abdominal distension for 15 days along with labored breathing. There was loss of appetite. There was no cough or contact with TB. On examination, height was 117 cm, weight was 17 kg. She had anemia with generalized insignificant lymphadenopathy. On systemic examination, she had hepatomegaly with other systems being normal. Investigations showed a hemoglobin of 8.02 g/dl, white blood cell count of 11,100/cumm (72% polymorphs and 27% lymphocytes), erythrocyte sedimentation rate of 100 mm at end of 1 h. HIV ELISA was negative. Her mantoux test was positive. Ultrasonography abdomen showed multiple upper retroperitoneal lymphadenopathy largest being 11 cm. Computed tomography (CT) chest showed left upper lobe consolidation with cavitation with patchy opacities in the right lung and necrotic mediastinal adenopathy suggestive of TB. Liver function tests were normal. She was started on four drugs ATT consisting of isoniazid (H), rifampicin (R), ethambutol (E), and pyrazinamide (Z). One month after starting ATT, she was detected to have a pericardial rub. Her echocardiography showed 1.7 cm pericardial effusion. She was continued on same ATT, and steroids were added which were then tapered after 2 months. At the end of 3 months of ATT, her ultrasound abdomen showed decrease in the size of adenopathy to 6 mm. At the end of 'hs of ATT, chest X-ray showed right pleural effusion with fissural effusion and left upper zone consolidation. At end of 5 months of ATT, she had gained 6 kg and on ophthalmological evaluation, she was found to have bilateral papilledema. Chest X-ray showed disappearance of effusion. She had no neurological manifestations. CT brain showed mild prominence of lateral and third ventricles. She was continued on same ATT. A repeat fundus examination was normal after 2 months. She was given ATT for 12 months in view of above manifestations. She had gained 9 kg in those 12 months and was alright on subsequent follow-up.