We report a case of a 30-year-old man who presented electively in our clinic with a history of intermittent high grade fever and right lower quadrant non-radiating abdominal pain for 1 year + 6 months duration, for which he consulted and treated in 5 different health facilities with no favourable evolution. On review of his systems; presence of non-productive cough, intermittent night sweat, loss of appetite, nausea but neither vomiting nor altered bowel habit. His past history is remarkable for appendicectomy 10 months ago after he consulted for similar complaints. Also, there is a history of contact with relative diagnose with pulmonary Tuberculosis (TB) 2 years ago. On examination; our patient was normotensive (BP=110\70mmHg) febrile to touch (Temp=38 c), lost 10% body weight within 6 months, ill-looking, asthenic with moderately pink conjunctivae and anicteric sclera. Head and neck exam revealed palpable submental, right and left anterior and posterior superficial cervical lymph nodes and right and left axillary lymph nodes. Nodes were mobile, non-tender with the left cervical node having the largest diameter of 4cm. Presence of fine inspiratory crackles on chest examination. Abdominal examination revealed grid-iron incision mark and mild tenderness around the right lower abdominal quadrant. A working diagnosis of Mesenteric adenitis + Lymph node Tuberculosis was made. A Full Blood Count (microcytic hypochromic anaemia with Hb=11g\dl, lymphocytosis), Chest X-Ray (showed parahila nodes), normal abdominal ultrasound, lymph node biopsy and histopathology (showed granulomas with langham giant cells and central caseation). Patient was then placed on a 6 month Anti-TB regiment under Direct Observational Therapy. Two weeks after onset of treatment evolution was favourable with normal body temperature and gain of appetite. Three months later, patient gained 4kg body weight, no palpable submental and axillary lymph node; there is mark reduction in size of cervical lymph nodes. Patient is fine now, has no complaint and has resume work.