Unusual presentations of tuberculosis.

Pulmonary, mediastinal, glandular, and spinal tuberculosis remain a scourge and an important clinical problem in many parts of the world where public health facilities do not match up with the requirements of a large necessitous population. Among the Bantu and Asiatic (a remarkably large number of whom are diabetic) populations of the Province of Natal in South Africa, tuberculosis is common and must always be borne in mind as the cause of a pulmonary or mediastinal lesion. Four unusual examples of tuberculosis in juvenile patients, in only one of whom was there a diagnostic clue, are presented. That it is not always possible to decide on radiographic grounds that a lesion is mediastinal and not pulmonary is made clear from three of these cases, and a fourth example of difficulty in deciding where a lesion (a) lies is illustrated.