Rationale: 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.

This study aimed to evaluate the role of platelet count (PLT) in the prognosis of patients with acute respiratory distress syndrome (ARDS). The data were extracted from the Medical Information Mart for Intensive Care database (version 2.2). Patients diagnosed with ARDS according to criteria from Berlin Definition and had the platelet count (PLT) measured within the first day after intensive care unit admission were analyzed. Based on PLT, ARDS patients were divided into four groups: PLT ≤ 100 × 109/L, PLT 101–200 × 109/L, PLT 201–300 × 109/L, and PLT > 300 × 109/L. The primary outcome was 28-day mortality. Survival probabilities were analyzed using Kaplan–Meier. Furthermore, the association between PLT and mortality in ARDS patients was assessed using a univariate and multivariable Cox proportional hazards model. Overall, the final analysis included 3,207 eligible participants with ARDS. According to the Kaplan–Meier curves for 28-day mortality of PLT, PLT ≤ 100 × 109/L was associated with a higher incidence of mortality (P = 0.001), the same trends were observed in the 60-day (P = 0.001) and 90‐day mortality (P = 0.001). In the multivariate model adjusted for the potential factors, the adjusted hazard ratio at PLT 101–200 × 109/L group, PLT 201–300 × 109/L, and PLT > 300 × 109/L was 0.681 [95% confidence interval (CI): 0.576–0.805, P < 0.001], 0.733 (95% CI: 0.604–0.889, P = 0.002), and 0.787 (95% CI: 0.624–0.994, P = 0.044) compared to the reference group (PLT ≤ 100 × 109/L), respectively. Similar relationships between the PLT ≤ 100 × 109/L group and 28-day mortality were obtained in most subgroups. PLT appeared to be an independent predictor of mortality in critically ill patients with ARDS.