Over a quarter of the world’s population is infected with Tuberculosis (TB)1 and 5-10% of cases of latent TB infection (LTBI) progress to active TB in an individual’s lifetime.Though screening tests are widely utilized for diagnosing LTBI, they are far from perfect.This describes a case of disseminated TB in a patient treated with aggressive immunosuppression after a false-negativeQuantiFERON-TB Gold test.