Introduction:
Miliary tuberculosis (TB) is the most common bacterial opportunistic infection in patients with advanced stage of acquired immunodeficiency syndrome, particularly in those not undergoing antiretroviral therapy (ART). The described patient was admitted to the infectious diseases ward due to disseminated TB affecting multiple organs.

Case description:
The patient was diagnosed with human immunodeficiency virus (HIV) infection 20 years ago, and initially received ART with good results. However, due to discontinuing ART for seve­ral years resulting in significant immunosuppression, the patient developed pulmonary TB at the end of 2020. Initial treatment was effective, but six months later, there was a recurrence in the form of severe miliary TB. The patient's condition was critical upon admission. Antituberculosis treatment and ART were applied, leading to an improvement in his condition. A year after Mycobacterium tuberculosis infection, follow-up renal function test revealed permanent kidney damage.

Conclusions:
This case highlights the importance of strict adherence to medical recommendations and consistent intake of ART. In the case of HIV/TB co-infection, attention should be given to efficient infection diagnosis and prompt initiation of antituberculosis treatment and ART. Severe opportunistic infections in HIV-infected patients can lead to chronic kidney diseases, which should be considered when planning the continuation of ART.