A Complicated Course of Pulmonary Tuberculosis With Cavitary Findings and Pleural Effusion

empyema. The patient was successfully treated with surgical drainage and guideline-directed anti-tuberculous therapy, resulting in clinical improvement. This case underscores the diagnostic challenges of extrapulmonary TB in non-endemic regions and highlights the importance of maintaining a high index of suspicion in patients from endemic areas, even when initial microbiologic testing is negative.