ABSTRACT
Even in the era of twenty-first century tuberculosis is still considered as a major health burden around the globe particularly around the Indian sub-continent. Though Pulmonary system is the principal site for Mycobacterium but extra-pulmonary involvement is not so common. Extra-pulmonary involvement can be seen in isolation or even with pulmonary involvement also. Immunocompromised individuals like HIV-affected individuals carries a greater risk for disseminated tuberculosis with involvement of multiple extra-pulmonary sites but Immunocompetent persons also can develop extra-pulmonary manifestation. Among all sites, Lymph nodes are the commonest in extra-pulmonary involvement. Though conventional Sputum smear examination and culture sensitivity is still reliable in diagnosis of pulmonary tuberculosis but are less helpful in extra-pulmonary cases due to its paucibacillary nature. Modern molecular methods in background of strong clinical suspicion with or without radiological evidences forms the pathway to confirm the diagnosis. These Diagnostic difficulty makes the delay in response to treatment in these patients