Cardiac tamponade due to tuberculosis is a well-known complication. However, acute erosion of TB lymphadenitis and its caseous material into the pericardium causing pericardial tamponade is rare. We describe a case of extensive mediastinal tubercular lymph node mass in which the caseous necrotic material found its way into pericardial sac causing acute pyopericardium and cardiac tamponade.
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