AbstractA 13‐year‐old boy presented with a history of respiratory infection that had progressed for 3 months. A chest X‐ray showed pathological findings that suggested endothoracic fascia compromise (Skarby sign). The thorax computerized axial tomography scan revealed multiple opacities in the fascia. A biopsy was performed, and a pathological lymph node with caseous material was obtained. Thirty days later, Mycobacterium tuberculosis var. hominis was obtained from the culture. The diagnosis of tuberculosis of the endothoracic fascia was confirmed. Treatment included 9 months with isoniacide and rifampin, and 2 months with pirazynamide and streptomycin, with excellent response. Vitamin B6 was added. Pediatr Pulmonol. 2006; 41:441–444. © 2006 Wiley‐Liss, Inc.