Melioidosis is a Gram‐negative bacterial disease caused by Burkholderia pseudomallei. It has got an increasing prevalence in India, although it is not endemic in the country. Rarely, this disease may pose a diagnostic dilemma, because of its similarities with tuberculosis in clinical, radiological, and pathological features. Mediastinal lymphadenopathy as a presentation is rare in melioidosis. Endobronchial ultrasound (EBUS) could be a useful technique in obtaining samples from necrotic mediastinal lesions. We report three cases of mediastinal melioidosis where EBUS‐guided fine needle aspiration (FNA) aided in early diagnosis.

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Tracheal tumor is a rare entity. Tracheal tumor may be a primary tracheal tumor or secondary to invasion from a mediastinal tumor (or a lymph node). These tumors are prone to cause critical airway obstruction which may require urgent care. Tuberculosis is one of the common differential diagnoses of mediastinal lymphadenopathy in TB endemic countries, though isolated tuberculous mediastinal lymphadenopathy without a lung involvement is rare. We report an extremely rare case of isolated paratracheal lymphadenitis due to tuberculosis, eroding the trachea and presented a lower tracheal tumor, which recurred again after complete debulking. Finally, the disease required a ‘Y’ stent placement, to stabilize the airway following the second recanalization. We discuss the incidence, differential diagnosis, and the bronchoscopic, interventional aspects of this entity.

In their hypothetical cohorts OXLADE et al. [1] predicted significant public-health benefits by changing from the 8-month to the 6-month (2HRZE/6HE to 2HRZE/4HR; where H5isoniazid, R5rifampicin, Z5pyrazinamide and E5ethambutol) regimen. Data from 2008 on drug-resistance surveillance from five World Health Organization (WHO) regions, i.e. Africa (Botswana), Western Pacific (China), Africa (Mozambique), SouthEast Asia (Burma) and Europe (Tajikistan), has shown isoniazid resistances among newly diagnosed cases varies from 9.0% to 26.6% and among previously treated cases from 11.7% to 74.4% [2]. India and China carry the greatest estimated burden of multidrugresistant (MDR)-tuberculosis (TB), together accounting for almost 50% of the total cases worldwide [2] The incidence of mono-drug resistance among new cases in tuberculosis endemic countries is also high [3]. Relapse cases (from all previously mentioned sites) had 5.5 times higher odds of harbouring MDR-TB strains when compared with new cases (95% CI 4.4-6.8), after adjusting for the clustering effect at the country level [2].