A 59-year-old man was admitted with a fever of unknown origin. Chest CT showed mediastinal lymphadenopathy. His symptoms improved after VATS biopsy and antibiotic treatment, and he was then discharged. The fever flared up again, however, and he was subsequently readmitted; a second CT scan showed a mediastinal abscess. Final drainage culture and biopsy culture showed Burkholderia pseudomallei. He was discharged after three weeks of antibiotic treatment with ceftazidime.