Abstract
Tuberculosis (TB) in renal transplant recipients presents important diagnostic difficulties because of the greater incidence of extra-pulmonary involvement, negative sputum smear results despite active disease and its atypical presentation, specifically reactivation of the latent form. BKV nephropathy was first reported in 1995, coinciding with the widespread use of immunosuppressive drugs, which can complicate the cores of 1-10% of renal transplant recipients. It is also not uncommon to find the existence of bacterial or fungal infections in the presence of an immuno-modulating virus like cytomegalovirus infection. Herewith, we describe a 67-year-old Saudi male who presented with deterioration of renal function and fever of unknown origin and was documented to have polyoma virus nephropathy and disseminated TB. To the best of our knowledge, this is the first report of such an association in the literature.