Abstract
Fungal and tuberculosis lung infections are considered differential diagnoses due to their clinical and radiological similarities, but they are not mutually exclusive. In rare cases, both entities may manifest in patients with immunosuppression, which is an indicator of high mortality. This is predominantly due to the low level of suspicion, which consequently results in a delay in treatment and thus represents a significant diagnostic challenge. This article describes the clinical evolution of an immunosuppressed patient with co-infection of pulmonary blastomycosis and tuberculosis to emphasize the importance of recognizing these associations in daily practice.