HIV-positive and AIDS patients are liable to acquire opportunistic infections [1], which can also include the urogenital system [2]. We report the first case of a prostatic abscess in an AIDS patient after an infection of the urinary tract with Salmonella typhimurium. Case report A 33-year-old homosexual man presented with complaints of dysuria, alguria, fatigue and persistent diarrhoea for several weeks. Examination revealed a 10 × 12 cm brown-red maculopapular lesion in the bilateral inguinal region. Biopsy confirmed the diagnosis of Kaposi's sarcoma. On presentation, the HIV test was positive, leukocytes were 4.08/μl. The CD4 : CD8 cell ratio was 0.3 (normal > 0.9) with CD3/CD4 helper cells 17.1% (normal range 28–50%) and CD8 T suppressor cells 63.8% (normal range 22–40%). A computerized tomography scan revealed multiple paratracheal and mediastinal lesions consistent with manifestations of Kaposi's sarcoma. Routine urine culture grew S. typhimurium, at a concentration greater than 105/ml. Treatment with ciprofloxacin 500 mg twice a day by mouth was initiated, and further infections with tuberculosis, pneumocystis, toxoplasmosis and cytomegalovirus were excluded. Three weeks after his first admission dysuria persisted despite antimicrobial treatment. As an area of the prostate showed contrast enhancement on the computerized tomography scan (Fig. 1), the patient was referred to the Department of Urology for further diagnosis and treatment.Fig. 1.: Computerized tomography shows the abscess in the right lobe of the prostate.On digital rectal examination a fluctuant, painful region in the right prostatic lobe was palpable. On transrectal ultrasound (TRUS) a 35 × 20 × 20 mm abscess was detected, which filled almost all of the right prostatic lobe. Using ultrasound guidance and local anaesthesia an 8 French pigtail drainage catheter was placed transperineally into the abscess cavity. Microbiology of the prostatic aspiration material also revealed S. typhimurium. The drain was left in place for 5 days and the abscess cavity was flushed once a day with a mixture of povidone–iodine/normal saline. The drainage decreased and symptoms resolved quickly. A normal TRUS was seen 5 days after the initiation of therapy and the drain was removed. No re-infection occurred, the prostate appeared normal on TRUS and on digital rectal examination during follow-up. Discussion This is the first description of a prostatic abscess caused by S. typhimurium in an AIDS patient. In the pre-antibiotic era, prostatic abscesses were known to be associated mainly with Neisseria gonorrhoeae. The spectrum of organisms infecting the prostate has changed over the years, with ‘common'urological bacteria now being the most prominent in prostatic infections. Nevertheless, HIV-positive and AIDS patients are particularly prone to any kind of infectious disease, and salmonella-related urinary tract infections are found in a significant number of these patients [1,2]. Whenever an HIV-positive or AIDS patient complains of urinary symptoms, the urologist must exclude prostatic involvement, such as acute prostatitis or a prostatic abscess. Recommendations regarding the treatment of prostatic abscesses include perineal drainage and transurethral resection [3]. We believe that the perineal approach carries fewer side-effects such as retrograde ejaculation, which is particularly bothersome to younger patients. It is well tolerated and leaves the option of repeatedly flushing the abscess area.