To the Editor: Dysphasia is rarely a presenting feature of tuberculous, more often associated with direct esophageal involvement. (1,2) Very few cases of tuberculosis mediastinal lymphadenopathy causing dysphasia have been reported from the Asian subcontinent and even fewer from the West. We came across a similar case, interesting not only from the geographical aspect but also in presentation.

A 45-year-old, nonsmoker, Asian postman complained of vomiting and dysphasia for 3 days. All investigations, including imaging, were normal. He was diagnosed with viral gastroenteritis and discharged. Six weeks later, he was readmitted with dysphasia, abdominal discomfort, lethargy, ...