2 Case Reports in Medicine Figure 1: Tonsillar architecture (H&E 4x). Figure 3: Noncaseating epitheliod cell granulomas (H&E 400x). Figure 2: Noncaseating epitheliod cell granulomas (H&E 100x). Figure 4: Acid fast bacilli (ZN oil immersion). improvement in symptoms and became asymptomatic with- in two months. The child is presently under followup to com- plete the prescribed regimen. 3. Discussion Extrapulmonary tuberculosis (TB) represents approximately 25% of overall tubercular morbidity [3]. Among extra pul- monary tuberculosis (EPTB), most common is lymph node tuberculosis while other forms are pleural tuberculosis, skele- tal tuberculosis, CNS tuberculosis, abdominal tuberculosis, genitourinary tuberculosis, and miliary tuberculosis, tuber- cular pericarditis is also seen. Tuberculosis of the oral cavity is uncommon and lesions may be either primary or secondary. Tongue and palate are the common sites whereas tonsillar tuberculosis is a rare localization with an incidence of less than 5% [4]. Tubercu- losis of the tonsil can result from infection by contact with material containing tubercle bacilli. Tonsillar TB commonly presents with sore throat and cervical lymphadenopathy. Miller [5] in 1963 concluded that with the advent of pas- teurized milk the incidence of tuberculosis came down still further. Tonsil is made up of lymphoid tissue and is situated at a site which is frequently drenched with infected sputum. Still tuberculous infection of tonsil is a rarity because of the antiseptic and cleansing action of saliva, inherent resistance of tonsil to tuberculous infection, presence of saprophytes in the oral cavity making colonization diﬃcult and the thick protective stratiﬁed squamous epithelial covering over tonsil [6]. Although tuberculosis of tonsil is now an uncommon ﬁnding, tonsillar granulomata are commonly seen in patients with poor host reaction due to alcoholism, HIV infection, and so forth. Predisposing factors for primary oral tuber- culosis include poor dental hygiene, dental extraction, perio- dontitis, and leucoplakia. It has been postulated that such in- fections are acquired by inhalation, with harbouring of dis- ease in Waldeyer’s ring. Diﬀerential diagnosis of oral and pharyngeal tuberculosis includes traumatic ulcers, apht- hous ulcers, hematological disorders, actinomycosis, syphilis, midline granuloma, Wegner’s disease, and malignancy [7]. Diagnosis of tonsillar tuberculosis is based on histopatholog- ical ﬁndings and the identiﬁcation of tubercle bacilli. Treat- ment is in the form of antituberculosis therapy. 4. Conclusion Tuberculosis of the tonsils might be suspected if the tonsils are enlarged unequally on the two sides and are associated with cervical lymphadenopathy. Patients seek medical advice due to sore throat and diﬃculty in deglutition. Tuberculosis is a severe and life-threatening disease. The number of new cases is increasing in both developed and developing coun- tries. Early detection and intervention is essential for cure. Isolated and primary tuberculosis of the tonsils in the