Trata-se do estudo de caso de uma criança com AIDS, atendida semanalmente em psicoterapia lúdica de orientação psicodinâmica durante um ano. São descritas e discutidas fantasias, angústias e defesas relacionadas às dificuldades emocionais de vivenciar sua doença e a perda de seus pais falecidos por complicações decorrentes da AIDS. Essa criança se expressou principalmente por meio de desenhos, utilizando inicialmente a negação como mecanismo de defesa. No decorrer do processo de ludoterapia, pôde usar outras defesas e formas de expressão. São observados sentimentos de abandono e de culpa relacionados com sua doença e com a morte dos pais, e fantasias inconscientes de haver provocado o falecimento dos genitores.

This is a case report of a child with AIDS who has taken part into psychotherapeutic sessions for an year. Considering the emotional difficulties experienced by the patient regarding the disease as well as the loss of his parents, caused by AIDS, an analysis based on psychodynamic psychology was conducted in relation to the unconscious fantasies, anxieties and defenses. At first, the child had used denial as a defense and expressed himself mainly through drawings. Along the play psychotherapy, the child was able to use less primitive defenses and express himself in other ways, such as games and drawings. The child's suffering seemed to be a result of abandonment and guilt feelings in relation to the disease and to his parents` death, as well as to unconscious fantasies of having provoked their death.