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.

Tuberculous Distal Biceps Tendon Rupture: Case Report and Review of the Literature

“…Laboratory tests, such as erythrocyte sedimentation rate, C-reactive protein, tuberculin skin test, and polymerase chain reaction for Mycobacterium tuberculosis , can help the surgeon to detect tuberculosis quickly [ 1 , 2 , 5 , 8 ].…”

“…Tenosynovitis and bursitis occur in about 2% of all extraspinal musculoskeletal tuberculosis cases. Tuberculosis involving the biceps tendon has been reported, but the tendons were still intact and could be treated with drugs and surgical debridement [ 1 , 2 ]. We report here an uncommon example of complete distal biceps tendon rupture due to disseminated tuberculosis.…”