Atypical mycoplasma pneumoniae, Hepatitis A with extrapulmonary tuberculosis presenting as cold agglutinin

Coexistence of atypical Mycoplasma pneumoniae, Hepatitis A with extrapulmonary tuberculosis in one patient presenting as cold agglutinin is rare. We report a case of 29-year-old male presenting with history of low grade fever, yellowish discoloration of eyes and pain in abdomen. On initial routine investigations diagnosed as pancytopenia, cold agglutinin disease, Hepatitis A, and Mycoplasma pneumoniae. Further investigation including bone marrow biopsy revealed granulomas and positron emission tomography-computed tomography showed tiny deep seated lymph node which on further excision confirms tuberculous lymphadenitis with positive acid fast bacillus. The patient responded well to treatment and recovered completely in due course of time.