ABSTRACT
Introduction: Prostate abscess is a rare complication of acute bacterial prostatitis and accounts for 0.5-2.5% of patients with prostatitis. IL-6 is an immunoregulatory cytokine with multiple biological activities, one of which is urothelial immune defense against bacteria. Prostate abscess clinical presentation in patients with diabetes mellitus and immunodeficiency does not follow the standard criteria. We registered an increased number of prostate abscesses in patients with COVID-19 within a limited time. Method(s): Patients with drainable abscesses according to transrectal ultrasound and pelvic MRI underwent transperineal drainage of the prostate abscess (8 patients of 11). A safety drain was installed into the abscess cavity;trocar cystostomy and antibiotic therapy were performed. Result(s): Within 6 months, 11 cases of prostate abscesses were detected;surgery was performed in 8 cases. However, 9 patients out of 11 had prostate abscesses in the peripheral zone. The average age was 72.8 (43-83) years. All patients received IL-6 inhibitors, followed by glucocorticoid therapy in eight cases. Leukopenia and no CRP elevations in the presence of fever were detected in eight patients. Procalcitonin test showed a bacterial infection only in 5 out of 11 patients. In all eight surgery cases, the aspirate was found in the culture with varying degrees of colonization: Klebsiella pneumonia 105 CFU (in seven patients), 107 CFU (in one patient). The average drainage time was 8 days. Two cases with minor abscesses were fatal. Conclusion(s): Based on the 6-month clinical data, we can estimate an increase in the number of prostate abscesses in patients undergoing COVID-19 therapy and detected a change in their standard localization. The rising number of abscesses within 6 months may be considered as a concomitant risk factor, in particular, due to prolonged urethral catheter-associated bladder drainage, immunosuppressive therapy, and the shutdown of the main local regulatory mechanism of the body's immune response to bacterial infection, mediated by IL-6.