• Xiyan Zhu, Hongyun Shu, Sisi Han, Jianhong Li, Haicui Su, and Qiaowen Li.
• Department of Cardiovascular Medicine, The Affiliated Qingyuan Hospital (Qingyuan People's Hospital), Guangzhou Medical University, Guangdong, China.
• Medicine (Baltimore). 2024 Nov 22; 103 (47): e40655e40655.

RationaleAcute myocardial infarction (AMI) is the leading global cause of death from cardiovascular disease, and the mortality rate increases in the presence of comorbidities such as renal abscess. The treatment of AMI combined with renal abscess is challenging, especially in combination with urinary tract obstruction, as percutaneous coronary intervention (PCI) can lead to progression of the renal abscess and deterioration of renal function. Currently, there is no consensus on the treatment of renal abscess in AMI.Patient ConcernsWe reported a case of a 74-year-old male patient with acute non-ST-segment elevation myocardial infarction combined with urinary tract obstruction. During his hospitalization, the hydronephrosis progressed to a renal abscess, which we punctured and drained. He ultimately underwent twice PCI and surgical relief of the ureteral obstruction shortly thereafter.DiagnosesHe was diagnosed with acute non-ST elevation myocardial infarction on admission, unfortunately, his hydronephrosis progressed into a renal abscess after the first PCI, which made further treatment difficult.InterventionsWe performed 2 coronary angiography examinations and implanted a stent in the stenotic coronary artery during the second procedure, which was preceded by an aggressive regimen of antibiotics and puncture and drainage of the renal abscess, which set the stage for the second PCI.OutcomesWe successfully performed coronary revascularisation to treat his coronary artery disease. One month later, his renal abscess drain was removed and the ureteral obstruction was finally resolved after undergoing percutaneous nephrolithotripsy for ureteral stone extraction.LessonsThe occurrence of renal abscesses is rare and may be unavoidable in those patients with preexisting structural lesions in the urinary tract where coronary angiography will increase the incidence of renal abscesses. Aggressive anti-infective therapy and drainage of pus by puncture will help the renal abscess to heal, and repeat coronary angiography has been shown to be safe in the meantime.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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