Imaging and management of prostatic abscess associated with the HIV syndrome

Clinical and pathologic studies have documented increasing involvement of the prostate in HIV-related disease. Imaging characteristics of prostatic abscess were examined in 7 patients who underwent transrectal ultrasound (TRUS), computed tomography, and magnetic resonance imaging. TRUS was the most valuable imaging modality in assessing and characterizing the degree of pathology. The most common sonographic feature was focal hypoechoic or anechoic nodules. Administration of intravenous antibiotics and transurethral unroofing of the abscess is the treatment of choice. Intraoperative bacterial, fungal, and mycobacterial cultures are mandatory. Only 3 of 6 surgically treated patients had positive intraoperative cultures.