Pericardial tuberculosis is a rare form of Mycobacterium tuberculosis infection seen commonly in endemic areas for TB, like Asia and Africa .Tuberculosis accounts for up to 4% of acute pericarditis and 7% cases of cardiac tamponade. It is common with background of immunodeficiency. It is a lethal condition but accurate diagnosis and prompt treatment can be life saving. We report a case of 30-year-old immunocompetent male who presented with sudden onset of breathlessness along with history of weight loss, low grade fever, chills and dry nonproductive cough since one month without any prior history of tuberculosis or history of exposure to tuberculosis. Initial workup for tuberculosis was negative in the case, only finding supporting diagnosis was pericardial fluid cytology findings.The case was diagnosed with pericardial tuberculosis by correlating clinico- radiological findings and pericardial fluid examination. The patient was started on antitubercular treatment and showed improvement.
