Abstract
Tubercular pyomyositis is a rare but distinct clinical entity which is difficult to diagnose especially in a patient with underlying autoimmune disease. The treatment is even more challenging if it is a multi-drug resistant strain. Here we report a patient with primary Sjögren's syndrome who presented with persistent inflammation of his right arm which was later diagnosed as multi-drug resistant tubercular pyomyositis. This case highlights the need for a high index of suspicion for tuberculosis in all cases of pyomyositis.