Kidney transplantation presents a susceptible point, and is related to infections; tuberculosis is a common and endemic etiology in a country like Mexico, where the most frequent presentation is the respiratory condition, the extrapulmonary is extremely rare and it is derived from immunosuppression conditions.33-year-old man with kidney disease of undetermined etiology, kidney transplant in 2003 (donor mother) with adequate evolution; presented with chronic graft nephropathy, with baseline creatinine of 1.8 mg / dL, immunosuppression with prednisone 10 mg every 24 hours, mycophenolate mofetil 500 mg every 8 hours and ciclosporin 100 mg every 12 hours; surgical intervention was performed due to acute abdomen, appendectomy and omentectomy with histopathological finding of tuberculosis, Dotbal, antiproliferative in suspension was started and decrease of calcineurin inhibitor. Adequate kidney function was recovered and maintained as well as control of the infectious disease during the maintenance period.The management of immunosuppression is vital to find the right dose to avoid rejection and allow an immune response to infection, together with antimicrobial treatment.