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A 38-year-old male presented to our hospital emergency department complaining of worsening of the voiding symptoms and fever of up to 38oC. She was under antibiotic treatment with levofloxacin for 5 days, for a diagnosis by pathological sediment and clinical courtship of dysuria and pollakiuria of acute prostatitis, without obtaining urine culture. She came to the hospital due to poor clinical evolution with impossibility of urination, bilateral and perineal testicular pain and worsening of general condition. Examination revealed a temperature of 38.6oC, maintained vital signs and presence of swelling in the perineal area with redness and local heat. A rectal examination could not be performed due to the intense pain caused by the attempt. 1. Complementary tests showed leukocytosis: 18,000 leuc/mm3, pyocytes in urine sediment with the rest of parameters within normal limits. The diagnostic imaging test performed is an abdominal and transperineal ultrasound, in which there is evidence of urine in the bladder and a multiloculated abscess pro. Without prior general contraindication and under sedation percutaneous drainage of the abscess is performed urgently and placement of a suprapubic catheter. An ultrasound-guided transperineal puncture was performed, obtaining purulent content and leaving 7 French pig-tail as drainage. 1. Cultures of the purulent content and urine were negative, probably distorted by the previously administered antibiotic. The evolution of the patient was favorable, reducing the output of the "pig-tail" during 24 hours and subsequently withdrawing. When the patient was afflicted with normal urethral mucus, she was discharged and ultrasound confirmed the normality of the prostatic zone one month later. |