History taking and physical examination is the cornerstone of medical diagnosis as will lead to correct diagnosis 90% of the time. We report a case of a 30-year-old black African man with lymph node tuberculosis diagnosed one year and six months later after onset of symptoms and signs. Clinicians especially those in resource-limited settings should go in for thorough history taking and complete physical examination which is the basis for correct clinical diagnosis, will provide valuable guide in deciding which tests to order and thus laboratory tests done for confirmatory purposes and also, has a cost-effective benefit for the patient.