Disseminated refractary tuberculosis with biceps tendon involvement in an immunocompetent patient

Abstract

Objective: The authors report a rare case of disseminated tuberculosis which had compromised the long head of biceps tendon and shoulder joint, during standard drug therapy.

Methods: On a first sight, the accurate diagnosis wasn’t accomplished and the patient had been treated with physiotherapy for rotator cuff tear. However, the patient presented with a fast growing mass in anterior region of the proximal third of the arm, complaining of pain increase. Aspirative punction of the mass revealed a yellow fluid and the laboratorial analysis confirmed infection by M. Tuberculosis. The patient was treated with surgical debridement and his drug therapy was changed.

Results: Resolution of infectious status and complete shoulder function restoration was succeeded.

Conclusion: Due to its high prevalence in Brazil, tuberculosis must always be considered as a possible cause of inflammatory joint disease, even in immunocompetent patients.