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A case of an adult male patient diagnosed with HIV and Hepatitis C co infection is presented. He had granu-lomatuos hepatitis and blood smear positive to Paracoccidioides brasiliensis concomitant to the detection of MDR Mycobacterium tuberculosis in sputum further complicated with reactivation of cytomegalovirus (possible pancreatitis and retinitis). Difficulties in diagnostic and therapeutic approach in a patient with multiple infections are reviewed.

Reportamos el caso de un varón de 54 años portador de VHC y VIH estadio SIDA quien tuvo hepatitis granu-lomatosa y frotis de sangre positivo a Paracoccidioides brasiliensis concomitante al hallazgo de Mycobacterhim tuberculosis multiresistente en esputo, que evolucionó con reactivación de citomegalovirus (pancreatitis probable y retinitis). Se describen las dificultades diagnósticas y terapéuticas en un paciente con múltiples infecciones. A case of an adult male patient diagnosed with HIV and Hepatitis C co infection is presented. He had granu-lomatuos hepatitis and blood smear positive to Paracoccidioides brasiliensis concomitant to the detection of MDR Mycobacterium tuberculosis in sputum further complicated with reactivation of cytomegalovirus (possible pancreatitis and retinitis). Difficulties in diagnostic and therapeutic approach in a patient with multiple infections are reviewed.