A female Somalian patient presenting with a clinical picture compatible with community-acquired bilateral lobe pneumonia failed to respond to empirical anti-microbial treatment. CT of the chest revealed cavitation of the apical segment of the right lower lobe, and this feature pointed to the correct diagnosis: tuberculous pneumonia, which was eventually confirmed with cultures taken during bronchoscopy. This is the first report of the use of chest CT in the diagnosis of lower lobe tuberculosis.