Kikuchi-Fujimoto disease (KFD) is a benign, self-limiting subacute necrotizing lymphadenitis with unknown aetiology that has a predilection for young Far East Asian women. It presents with fever, fatigue and lymphadenomegaly and is often misdiagnosed. We report an unusual presentation in a South Asian woman with isolated mediastinal lymphadenopathy masquerading as tuberculosis. There is only one other reported case in the literature presenting with isolated mediastinal lymphadenopathy.