A 2-month-old boy presented with fever for 20 days along with breathlessness. There is no contact with TB. On examination he had decreased air entry on left side with shift of mediastinum to opposite side. Chest X-ray showed right upper zone pneumonia with mediastinal adenopathy and obstructive emphysema on the left side. CT chest showed necrotic mediastinal adenopathy with extrinsic compression of left main bronchus with resultant obstructive emphysema of left lung. Mantoux test was positive. Child was started on four drugs ATT with steroids. At 4 months of age, he weighed 5.25 kg and at 6 months was 6 kg. On follow-up, he was asymptomatic and ATT was stopped after 6 months.