A 6-month-old boy presented in July 2009 with breathlessness for 8 days and cough, fever for 3 days. There was no foreign body aspiration or contact with TB. On examination, weight was 6 kg, height was 62 cm, and there was decreased air entry on the right side with shift of mediastinum to left side. Other systems were normal. Chest X-ray showed obstructive emphysema on right side with shift of mediastinum to opposite side. A CT chest with virtual bronchoscopy showed an endobronchial lesion in the distal right main bronchus causing obstructive emphysema with enlarged necrotic mediastinal lymph nodes suggestive of TB. All family members were screened for TB and maternal uncle was detected to have cavity in right mid zone. The child was started on four drugs ATT consisting of HRZE along with prednisolone (2 mg/kg/day) which were tapered gradually. In September 2009, his weight was the same and chest X-ray was also the same. CT chest showed persistence of endobronchial lesion and increase in size of mediastinal nodes. He underwent a bronchoscopy and TB culture was negative. In February 2010, his weight increased to 9 kg and in July 2010, his chest X-ray was normal. ATT was stopped in July 2010. He received ATT for 12 months in view of delayed response to ATT.