title: 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.
  
  
  CONCLUSIONS
  Due to its high prevalence in Brazil, tuberculosis must always be considered as a possible cause of inflammatory joint disease, even in immunocompetent patients.
authors.affiliation: Resident, Orthopedics and Traumatology, Hospital Universitário Clementino Fraga Filho (HUCFF), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Dos Reis Oliveira
authors.affiliation: Member, Shoulder and Elbow Group, HUCFF-UFRJ. Orthopedist, National Institute of Traumatology and Orthopedics (INTO, Instituto Nacional de Traumatologia e Ortopedia), Rio de Janeiro, Brazil.
authors.forename: Márcio
authors.initials: M
authors.lastname: Schiefer
authors.affiliation: Medical Assistant, HUCFF-UFRJ (Shoulder and Elbow Group). Master in Orthopedics and Traumatology, UFRJ, Rio de Janeiro, Brazil.
authors.forename: Marcos Britto
authors.initials: MB
authors.lastname: da Silva
authors.affiliation: Clinic Head and Medical Residence Program Coordinator, Traumatology and Orthopedics Clinic, HUCFF-UFRJ. Master in Orthopedics and Traumatology, UFRJ, Rio de Janeiro, Brazil.
authors.forename: César
authors.initials: C
authors.lastname: Fontenelle
authors.affiliation: Resident (R2) in Orthopedics and Traumatology, Hospital Universitirio Clementino Fraga Filho (HUCFF), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
authors.forename: Yonder Archanjo Ching-San
authors.initials: YA
authors.lastname: Júnior
authors.affiliation: Head, Department of Orthopedics and Traumatology, School of Medicine, UFRJ. Associate Professor, School of Medicine, UFRJ, Rio de Janeiro, Brazil.
authors.forename: José Sérgio
authors.initials: JS
authors.lastname: Franco
keywords: Infection; Rotator cuff; Shoulder; Tuberculosis osteoarticular