We report a case of 33 years old male patient, ex prisoner, in drugs, malnourished, with severe back pain and paraplegia. The CT reveals lytic lesions in the vertebral body of T11, further an injury consistent with psoas abscess. These findings, associated with an antecedent of contact with BK positive person suggest the spinal TB diagnosis, that is confirmed by histology and culture. Conclusion: Spinal TB should be part of the differential diagnosis in patients with symptoms such as the presented in this case, especially in high prevalence areas like ours. The CT and MRI are first line tools in the diagnosis of this condition, which must be confirmed with biopsy and culture.