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Tuberculous retropharyngeal, parathoracic, and iliopsoas abscess is a rare entity, and was regarded as secondary to vertebral tuberculosis. Because of its deep location and insidious course, it has always been a diagnostic and therapeutic challenge. We report a case of vertebral tuberculosis complicated with multiple para-spinal deep abscesses. The magnetic resonance imaging (MRI) and computed tomography (CT) scans confirmed the image diagnosis (Figures 1A and 1B), and microbiologic culture of the abscess grew Mycobacterium tuberculosis. After receiving antituberculosis medicine and CT-guided percutaneous drainage, the patient’s condition improved. The antituberculosis drugs in conjunction with percutaneous drainage under image guidance are an effective therapy in such a patient. A37-year-oldmanpresented toourhospitalwitha1-month history ofmiddle back pain, dysphagia, and a low-grade fever. The patient had a history of psoriasis vulgaris without medication. He did not have a history of diabetes mellitus, malignancy, or did not take any other immunosuppressive agents. His wife, of Vietnamese descent, had a history of pulmonary tuberculosis 4 years prior, and she had received a total of 6 months of antituberculosis treatment. His initial laboratory evaluation showed leukocytosis (white blood cell count of 10,720 cells/mm) with predominant neutrophils (81.6%) and elevated levels of C-reactive protein (12.44 mg/dL). Chest radiograph revealed a barely-visible bilateral paraspinal soft-tissue component along the spine column. Plain abdomen X-ray showed obliteration of the right psoas shadow. Ultrasonography disclosed an homogenous bulky fluid collection measuring 10 8.5 cm in the right psoas muscle. CT scan showed a huge abscess measuring 8.5 9.2 20 cm in the right psoas muscle and 4.0 2.9 5.4 cm in the left psoas muscle (Figure 1B). Subsequently, MRI analysis confirmed multiple vertebral

journal of microbiology immunology and infection

Vertebral tuberculosis complicated with retropharyngeal, parathoracic, and huge iliopsoas abscess, successfully treated with image-guided percutaneous drainage