Patient JMD, 51 years, black, masculine sex, presenting has one month cervical nodule the right, of hardened consistency, painless, with redness and local heat, not adhered the deep plans, culminating with fistulization and purulent secretion elimination. With the injury they associate mediastinal lymph in adjacent previous cervical region, nocturnal daily vespertine fever, sudorese and slimming of 04kg in the last month. Laboratorial examinations had shown hemoglobin of 6,1g/dl, leukocytes with 8.320 cells/mm3 with normal distinguishing counting; speed of hemosedimentation of 92mm/1st hour; total proteins of 7mg/dl and equal albumen 1,5mg/dl. The sorologies IgG and IgM for cytomegalovirus, toxoplasmosis, rubella, herpes simplex type 1 and 2, anti-HIV and VDRL had been not reacting; the PPD was not reactor, and the enlarged in sputum, refusal (three samples). The thoracic and abdominal computerized tomography had revealed without abnormalities. The secretion culture of the nodule was positive for Mycobacterium tuberculosis. The patient was directed to the Service of Dermatology of the PUC-RJ, where she was carried through biopsy of the nodule, that disclosed presence of granulomas of strange body, fabric of granulation and microcalcifications, beyond bacilli to the coloration of Ziehl-Neelsen, being instituted project I (rifampicin, isoniazid and pyrazinamide) for tuberculosis, with gradual improvement of the general and nutritional state, presenting regression and healing of the coetaneous injury of the patient.