A 35-year-old HIV positive male presented with dyspnoea and chest pain was diagnosed having acute pericardial and pleural effusion. Microfilaria was detected from blood as well as from the pericardial and pleural fluid and from urine. CD4 count was 123 cells microl. The patient was receiving treatment with antiretroviral therapy and Cotrimoxazole for last 4 months. The patient had no opportunistic infection and no symptoms suggestive of filarial infection in the past. This is for the first time we are reporting high microfilarial load (1000/ml) from blood in HIV positive patient, where microfilaria was also demonstrated from the pericardial and pleural fluid and from urine.