A 58-year-old man presented with a 1-month history of dull right groin pain without back pain or fever. He denied a history of steroid use, diabetes mellitus, human immunodeficiency virus infection, intravenous drug use, or recent dental procedures. Physical examination revealed an indurated right groin without a cardiac murmur. Laboratory studies revealed the following: white blood cell count, 17000/μL (83.1% segmented neutrophils); hemoglobin, 9.3 g/dL; platelet count, 757000/μL; creatinine, 0.6 mg/dL; and 1 of 2 blood cultures positive for Streptococcus intermedius. Results of computed tomography of the thigh revealed a 10.9 × 5.7 × 3.8 cm³ fluid collection, representing rupture of the fluid from the spine into the iliopsoas and retroperitoneum (image A). A magnetic resonance image of the lumbar spine demonstrated abscess extension from the T12-L1 neural foramen and vertebral end plate and disk inflammation consistent with spondylodiscitis (image B). The patient was given intravenous ceftriaxone (2 g every 12 hours) for 12 weeks. All cultures of the fluid collection and subsequent blood cultures were negative for S intermedius.