A 46-year-old Hispanic male from Ecuador presented with fever, malaise, weight loss, and dyspnea. He was HIV-positive with a CD4+ cell count of 4/microL. He was hospitalized, and therapy for community-acquired pneumonia with broad-spectrum antibiotics was started. Both Histoplasma capsulatum and Cryptococcus neoformans were cultured from bronchial lavage, blood, and bone marrow specimens. Despite aggressive therapy with amphotericin B, the patient died 8 days after admission.