The case describes a 10-year-old female patient admitted to the Developmental Neurology Clinic due to gait disturbances and lower limb muscle weakness of sudden onset. Neurological examination revealed features of pyramidal syndrome, including hyperreflexia in the lower limbs, spastic paraparesis, and a left-sided Babinski sign. Magnetic resonance imaging findings indicated a pathological fracture of the thoracic 6 vertebral body and a solid pathological lesion at the T5, T6, T7 level. Chest computed tomography identified pathological lymph nodes in the mediastinum. Differential diagnosis for Pott's disease and malignancy was recommended. Histopathological biopsy of the pathological mediastinal lymph nodes ruled out neoplastic changes. Due to suspected tuberculosis infection, a QuantiFERON-TB test was performed, which returned positive. Based on the overall clinical presentation, imaging, laboratory, and microbiological findings the patient was diagnosed with tuberculosis and started on pharmacological treatment. Neurosurgical consultation led to the decision to proceed with surgical stabilization of the vertebrae.