A case report of a 16-year-old male with extrapulmonary tuberculosis presenting as multiloculated mediastinal, pleural, and paravertebral fluid collections with chest pain, Eldoret, Kenya.

Key Clinical Message: Extrapulmonary TB presenting as multiloculated pleural fluid collections is rare in persons less than 18 years of age, but it can occur. High index of suspicion is important in establishing early diagnosis and treatment to reduce morbidity and mortality. Abstract: We present a case report of an immunocompetent African young man who presented with persistent chest pain and fever, and was diagnosed with extrapulmonary tuberculosis (EPTB) following chest CT scan, pleural biopsy histopathology examination, and Ziehl-Neelsen (ZN) staining, and pleural fluid Gene Xpert studies.