Successful eradication of renal allograft abscess by CT-guided percutaneous pigtail drainage: A case report

Renal allograft abscess is an infrequent complication in kidney transplant recipients. The mainstay of treatment is adequate drainage and optimal antibiotic administration. PATIENT CONCERNS: A 25-year-old female who presented with dysuria, frequency, chills, fever, and allograft pain was initially diagnosed with a urinary tract infection complicated by septic shock 15 months after kidney transplantation. Ultrasound depicted a hypoechoic mass and contrast-enhanced computed tomography (CT) revealed a lesion with no enhancement in the renal allograft. CT-guided percutaneous pigtail drainage placement was implemented. DIAGNOSES: Blood-stained pus was aspirated from the lesion in the renal allograft. The aspirate culture revealed Escherichia coli and Proteus mirabilis with an antibiogram consistent to urine culture. The diagnosis of renal allograft abscess originated from urinary tract infection was confirmed. INTERVENTIONS: The patient underwent CT-guided percutaneous pigtail drainage and conducted culture of the aspirate. OUTCOMES: The patient’s symptoms immediately abated after drainage and renal allograft function recovered normally. Ultrasound and CT showed total regression of the renal allograft abscess at the 1-month outpatient follow-up. LESSONS: Heightened alertness should be attached to that severe urinary tract infections presenting with sepsis shock and antibiotic treatment non responders are likely to progress to renal allograft abscess in kidney transplant recipients. CT-guided percutaneous pigtail drainage was a safe and effective minimally invasive treatment.