Tuberculosis is one of severe infectious complications in patients on hemodialysis and after kidney transplantation. Incidence of disseminated and generalized forms is high, whereas clinical symptoms are weak and nonspecific. An aggressive generalized form of tuberculosis was observed in a kidney transplant recipient. M. tuberculosis, the antigen and DNA were registered only a few days before death. Disseminated foci in the lungs were seen on CT image only in the agonal period in spite of multiple x-ray investigations. Thus, our experience and experience of other investigators evidence that if recipients of renal transplant have fever of unknown genesis and do not respond to standard antibiotic therapy, tuberculosis should be suspected and a course of specific antituberculosis therapy should be started as early as possible.