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Marcus Ground,1 Thijmen Veenendaal,1 Daniel Rexie Chiluzi,1 Geoffrey Nkhonjera,2 Arie C Glas,1 Lisanne Glas-van Dijk1 1Mulanje Mission Hospital, Mulanje, Malawi; 2Oncology Department, Queen Elizabeth Central Hospital, Blantyre, MalawiCorrespondence: Marcus Ground, Email marcus.ground@gmail.comAbstract: We present the case of an HIV-positive man diagnosed with multicentric Castleman disease (MCD) associated with human herpesvirus 8 (HHV8) infection, complicated by renal failure. This subtype of an otherwise rare disease is a complication of HIV and HHV8 infection. The diagnosis and management of HHV8-MCD in the developing world is challenging—in part due to its rarity, but largely due to the limited access to histology and other laboratory services. Our case presented with a confusing constellation of symptoms and was diagnosed with MCD on histology. Here we discuss the epidemiology, pathogenesis, diagnosis, and treatment of HHV8-MCD in the context of HIV infection in a resource-limited setting, in the hope that greater awareness will lead to more prompt recognition.Keywords: Castleman disease, HIV, lymphoproliferative disorders, case report, human herpesvirus 8