Many case reports have described the formation of intramedullary abscess in patients with active tuberculosis infection or Mycobacterium tuberculosis in the purulent fluid in the abscess [22–30]. Most of these patients had a good recovery after surgery and the initiation of antituberculosis medications. Radiographically, the formation of a T2-weighted hyperintensity on magnetic resonance imaging studies, called the precipitation sign, can indicate a Mycobacterium tuberculosis-infected intramedullary abscess .