A Mediastinal mass with an unusual etiology – Unravelling the Diagnosis

Melioidosis, caused by Burkholderia pseudomallei, is an infectious disease endemic to tropical regions.This is often misdiagnosed as tuberculosis (TB) or lung malignancy due to overlapping clinical and radiological features.This case report describes an elderly male with type 2 diabetes mellitus who presented with chronic cough and weight loss.Diagnostic evaluation, including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of subcarinal mediastinal lymph node confirmed pulmonary melioidosis.This case underscores the diagnostic complexity of melioidosis, particularly in patients presenting with chronic symptoms, and highlights the role of diagnostic modalities such as EBUS-TBNA for prompt recognition and initiation of targeted antibiotic therapy.This report emphasizes the need for increased clinical awareness in endemic regions to reduce delays in diagnosis and improve prognosis.