The first patient, a 33-year-old Kuwaiti (Middle Eastern) female was referred to the TB Control Unit of the Chest Diseases Hospital in January 2003 with the diagnosis of cold abscess of the right gluteus medius muscle with adjacent trocentric involvement. Both the hip joints and psoas muscles were normal. Ultrasonic guided aspiration from the abscess yielded thin pus that was positive for acid-fast bacilli. The culture was grown from the aspirate (isolate Kw 176) and identified as M. tuberculosis. The drug susceptibility performed with BACTEC 460 TB system showed that the bacilli were sensitive to isoniazid (INH), streptomycin (SM), pyrazinamide (PZA) and ethambutol (EMB) but resistant to rifampin (RMP). She was treated with a regimen of INH, SM, PZA and EMB for seven months and fully recovered.