A 38-year-old man came to the emergency department of our hospital due to worsening voiding symptoms and fever of up to 38ºC. He had been on antibiotic treatment with levofloxacin for 5 days, due to a diagnosis by pathological sediment and clinical picture of dysuria and pollakiuria of acute prostatitis, without obtaining a urine culture.
He came to the hospital due to poor clinical evolution with inability to urinate, bilateral testicular and perineal pain and worsening general condition.
Examination revealed a temperature of 38.6ºC, vital signs were maintained and there was swelling in the perineal area with redness and local heat. Rectal examination was not possible due to the intense pain caused by the attempt.

Complementary tests showed leukocytosis: 18,000 leukocytes/mm3, pyocytes in the urine sediment, the rest of the parameters being within normal limits.
The diagnostic imaging test performed was an abdominal and transperineal ultrasound, which revealed the presence of urine in the bladder and a multiloculated prostatic abscess.
Without prior general contraindication and under sedation, percutaneous drainage of the abscess and placement of a suprapubic catheter were performed urgently. An ultrasound-guided transperineal puncture was performed, obtaining purulent content and a 7 French pig-tail was left as drainage.

Cultures of the purulent content and urine were negative, probably falsified by the antibiotic administered previously.
The patient's evolution was favourable, decreasing the pig-tail debit for 24 hours and subsequently withdrawing it. As he was afebrile and with normal urethral urination, he was discharged and the prostate area was found to be normal ultrasonographically one month later.

