Tuberculosis (TB) has recently been found to cause serve infection in patients post transplantation and therefore patient care after liver transplantation should also focus on the possibility of TB developing post liver transplantation one such case study was a 31 – year –old female who underwent liver transplantation for decompensate Wilson an cirrhosis Aug 3, 1999. The post transplantation course was smooth. The immunosuppressant regimen consisted of neural and steroid –resistant rejection developed on- Aug.28 .the neural was switched to tacrolimus following which she had good liver function. Three weeks later, on Nov 18, persistent spiking fever was noted. The chest showed infiltrative lesions in the left lung. The CMV titer was increased. Bronchoscopy was performed. No virus infection was identified. The patient was treated as CMV pneumonias and the immunosuppressive agents were discontinued. However, steroid-resistant rejection developed on Aug.28. The neural was switched to tacrolimus following which she has good function. Three week later. On Nov 18, persistent spiking fever was noted. The chest showed infiltrative lesions in the left lung. The CMV titer was increased. Bronchoscopy was performed. No virus infection was identified. The patient was treated as CMV pneumonitis and the immunosuppressive agents were disconnected. However no improvement noted. Therefore, open lung biopsy was done on Dec 29 and tuberculosis was confirmed. The patient was then treated with anti-TB therapy with which the chest lesions gradually improved.