A 41/2-year-old female child presented with fever for 11/2 months and cough for 5 months. There was no contact with a patient suffering from TB. A general practitioner had treated her with anti-TB therapy (ATT) for 2-3 months in view of positive Mantoux test. On examination, weight was 16 kg, and height was 98 cm. Both upper limb pulses were not felt and lower limb pulses were low volume. Blood pressure in the upper limbs could not be recorded and in the left lower limb was 122/80 mmHg. Systemic examination was normal. Chest X-ray showed bilateral collapse consolidation with prominent aortic knuckle. Hemoglobin was 10.1 g/dl, white blood cell (WBC) count was 15,100/cumm (70% polymorphs, 29% lymphocytes), erythrocyte sedimentation rate (ESR) of 17 mm at the end of 1 h. Mantoux test was negative and sputum smear did not show any acid-fast Bacilli. HIV ELISA was negative. TB Gold test was also negative. Echocardiography showed dilated ascending and descending aorta including abdominal aorta with hyperechoic intima, suggestive of aortoarteritis. Computed tomography angiography of the aorta showed aneurysmal dilatation of ascending aorta, arch and descending thoracic and suprarenal abdominal aorta with bilateral blocked subclavian artery. There was a small caliber infrarenal abdominal aorta. A bronchoalveolar lavage could not be done due to poor cardiac condition. She was started on four drugs of ATT and subsequently detected to have hypertension, for which she was started on methyldopa and nifedipine. Oral prednisolone was started at 1 mg/kg/day. An opinion of interventional radiologist was taken, and it was found to be not amenable to dilatation. She is on regular follow-up.