Malakoplakia and xanthogranulomatous pyelonephritis treated with nephrectomy

Abstract

Rationale: Malakoplakia and xanthogranulomatous pyelonephritis are chronic inflammatory conditions of the kidney characterized by the infiltration of inflammatory cells. Patient concerns: An 82-year-old female patient had a history of hypertension, type 2 diabetes mellitus, dyslipidemia, and end-stage renal disease under hemodialysis. She was admitted repeatedly 4 times within 4 months due to urosepsis. Diagnosis: The enlarged right kidney with a low-density lesion at the right middle calyx, and a well-enhanced ureter were noted on the computed tomography scan. Therefore, xanthogranulomatous inflammation was suspected. Semi-rigid ureteroscopy with biopsy was performed, and xanthogranulomatous inflammation of the ureter was confirmed on the pathology report. Interventions: After right open radical nephrectomy was performed, the final pathology report revealed malakoplakia with xanthogranulomatous pyelonephritis. Outcomes: After the surgery, she has no longer suffered from urosepsis for 8 months, and there were no adverse event or recurrence noted. Lessons: With this case report, we aim to emphasize that these 2 diseases are not mutually exclusive, but they may exist simultaneously in the same patient.

Urinary Tract Infection in Hemodialysis-Dependent End-Stage Renal Disease Patients

“…With regard to UTIs, the symptoms of bacterial cystitis (eg, pollakisuria, urgency, and sense of residual urine or miction pain) affect the quality of life, and pyelonephritis might become urosepsis, 6 , 7 which is a life-threatening disease, especially in hemodialysis-dependent ESRD patients. Understanding urinalysis and urinary bacterial cultures in hemodialysis-dependent ESRD patients is necessary.…”

Malakoplakia of Larynx: A Case Report and Literature Review of Localized Malakoplakia of Larynx

“…It has been mainly described in immunocompromised patients or patients with chronic debilitating conditions, like patients with HIV/AIDS, autoimmune disease, diabetes mellitus, tuberculosis, alcohol abuse, post-transplant, etc. [3][4][5][6][7][8] And most patients have bacterial infections, micro-organisms, such as Escherichia coli, Staphylococcus aureus, Rhodococcus equi, and so on were mentioned in some reports about malakoplakia. [9][10][11] As the initial presenting symptoms are non-specific and mainly depend on the location of the lesion, so the diagnosis of malakoplakia depends on the histological discovery of Michaelis-Gutmann bodies (MG bodies).…”