This patient was identified from the community as having symptoms and risk factors compatible with tuberculosis. The CXR findings prompted AFB testing which was positive, and she was commenced on anti-TB therapy. While on this, she developed RIF pain which was initially attributed to a TB hydrosalpinx but further assessment demonstrated a L3/L4 tuberculous discitis with anterior paraspinal and large complex right iliopsoas abscess.

This abscess was aspirated under ultrasound guidance (>500 mL) and positive for TB on culture.

The majority of changes showed improvement or resolution on follow up imaging.