Standard multidrug antituberculous chemotherapy remains the gold standard of treatment. In India, per the Revised National Tuberculosis Control Programme, the directly observed short-course chemotherapy strategy (DOTS), a globally accepted standard for treatment of all forms of tuberculosis, is followed.13 In the initial intensive phase of treatment, isoniazid, 10 to 15 mg/kg; rifampicin, 10 mg/kg; pyrazinamide, 15 to 30 mg/kg; and ethambutol, 15 to 25 mg/kg, are given 3 times a week on alternate days for 2 months, while in the immediate continuation phase, isoniazid and rifampicin are given in the same doses 3 times a week for 4 months. DOTS has the advantage of directly supervised treatment that increases the cure rate, decreases transmission of disease, and prevents emergence of multidrug-resistant tuberculosis while minimizing adverse effects due to drugs. In SCD resulting from tuberculous lymphadenitis, arthritis, or osteomyelitis, surgery in the form of aspiration, incision and drainage, debridement, curettage, and partial or total excision of the cold abscesses and underlying pathological lymph nodes or ribs may be necessary. Surgical excision becomes essential in patients with persistent residual disease despite the full course of chemotherapy or in instances of infection by atypical mycobacteria, in which the response to conventional chemotherapy is poor.