<p>A 37-year-old male security officer presented with fever, severe low back pain radiating to the left lower leg and diminished mobility for one week. His lumbar spine X-ray was unremarkable, but his inflammatory markers, including CRP, ESR, and neutrophils, were high. CT scan with contrast showed rim enhancing fluid collection within the left obturator foramen with inflammatory change in the mesorectal fat. Confirmatory MRI scans depicted inflammatory change in the left piriformis muscle and a localized collection without any abnormality in the spine. Urgent CT guided aspiration was performed, and the sample sent for microbiological analysis. Intravenous antibiotics commenced and continued for two weeks.</p>