Renal allograft abscesses following transplant: Case report and literature review

Intrarenal and perinephric abscess formations are infrequent infectious complications in kidney allograft recipients. A 37-year-old man who was a victim of mustard gas chemical weapons from the Iran-Iraq war received a live-donor kidney transplant for end-stage renal disease. The posttransplant course was complicated by clinical rejection, which subsided after a 2-week infusion of antithymocyte globulin. One month subsequent to this, the patient presented with renal allograft dysfunction and multiple intrarenal abscesses. Culture from the purulent aspirate of a percutaneously drained renal abscess revealed multidrug-resistant Pseudomonas aeruginosa. A concomitant acute cytomegalovirus infection was detected based on positive serologic tests. Treatment with intravenous meropenem (3 g/day for 3 weeks) and oral ciprofloxacin was begun, which resulted in the complete resolution of the intrarenal abscesses. To our knowledge, this report represents the first description of pseudomonal renal abscesses in a renal transplant recipient. A review of the relevant literature is presented.