Tuberculosis (TB) and cryptococcosis cause severe morbidity and mortality in HIV-infected individuals in sub-Saharan Africa. However, cryptococcosis and TB co-infection is rare. We present a case of pulmonary cryptococcosis co-existing with pulmonary TB in a 42 year old Nigerian woman who had received Highly Active Antiretroviral Therapy (HAART) for about 6 months with CD4 count of 98 cells/mm 3 . In the second month of HAART, she developed smear positive TB and was commenced on anti-TB therapy. Following initial improvement, she developed new onset cough, low grade fever, weight loss, breathlessness and chest pain. Repeat sputum Acid Fast Bacilli (AFB) was negative but GeneXpert/MTB/Rif detected Mycobacterium tuberculosis (MTB) with no
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