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AIDS Research and Therapy Jan 2024Malakoplakia is a rare chronic granulomatous disease characterized by the presence of Michaelis-Gutmann bodies (MGBs) within histiocytic aggregates. It predominantly...
BACKGROUND
Malakoplakia is a rare chronic granulomatous disease characterized by the presence of Michaelis-Gutmann bodies (MGBs) within histiocytic aggregates. It predominantly affects immunocompromised individuals, including those living with Human Immunodeficiency Virus (HIV).
CASE PRESENTATION
We present a unique case of bifocal malakoplakia in a 49-year-old man, previously with Coronavirus disease 2019 (COVID-19) and HIV positive, presented with respiratory symptoms, weight loss, and lymphadenopathy. He had various infections including Non-Tuberculous Mycobacteria (NTM), Cytomegalovirus (CMV), and Candida, with evolving lung and gastrointestinal issues. Despite treatment attempts, he deteriorated due to respiratory distress, multi-organ failure, and coagulopathy, leading to his unfortunate demise.
CONCLUSION
This report presents a distinctive and complex case of malakoplakia in an HIV-positive patient, a rare inflammatory disorder originally described by Michaelis and Gutmann in 1902. The hallmark Michaelis-Gutmann organisms were observed, confirming the diagnosis. While typically affecting the urinary tract, this case demonstrates the exceptional ability of malakoplakia to manifest in various organ systems, including pulmonary, gastrointestinal, and more. Although Escherichia coli is a prevalent associated pathogen, the exact cause remains elusive. Treatment, often involving surgical excision and antibiotic therapy, underscores the challenging nature of managing this condition in immunocompromised individuals.
Topics: Male; Humans; Middle Aged; HIV; Malacoplakia; HIV Infections; HIV Seropositivity; COVID-19
PubMed: 38185638
DOI: 10.1186/s12981-024-00592-w -
International Journal of Surgery Case... Nov 2023Malakoplakia is a rare inflammatory condition that generally occurs in immunocompromised individuals and is thought to be secondary to a bactericidal defect in...
INTRODUCTION AND IMPORTANCE
Malakoplakia is a rare inflammatory condition that generally occurs in immunocompromised individuals and is thought to be secondary to a bactericidal defect in macrophages.
CASE PRESENTATION
In this report, we present the case of a 50-year-old multiparous patient who presented with chronic pelvic pain. Ultrasonography revealed a suspicious left lateral-uterine mass. Laparoscopic exploration showed an inflammatory mass in the left adnexa adherent to the uterus, peritoneum, and meso-sigmoid. The patient underwent a total hysterectomy with bilateral salpingo-oophorectomy and peritoneal biopsy. Histological findings were consistent with a left adnexal location of malacopakia, and Bacteriological analysis revealed Escherichia coli infection sensitive to ciprofloxacin. At the 6-month follow-up, no recurrence was observed. The patient's condition improved following surgery and antibiotic treatment.
CLINICAL DISCUSSION
Genitourinary malakoplakia is more common in women and has no specific clinical, biological, or radiological features. Diagnosis is based on histological criteria, notably the presence of Michaelis-Gutmann bodies. Advances in our understanding of the pathophysiology of malakoplakia have made it possible to consider medical treatment options, mainly through the use of antibiotics. However, in cases where the organ is severely affected, surgical excision is recommended.
CONCLUSIONS
To summarize, adnexal malacoplakia is a highly uncommon disease that may be mistaken as a malignant tumor. The diagnosis is established through histological examination. The usual treatment is a combination of surgical excision followed by targeted antibiotic therapy, as the diagnosis is often not made until after surgery.
PubMed: 37939569
DOI: 10.1016/j.ijscr.2023.109012 -
Journal of Nephrology Dec 2023
Topics: Humans; Malacoplakia; Urinary Tract Infections; Acute Kidney Injury
PubMed: 37924475
DOI: 10.1007/s40620-023-01796-5 -
ANZ Journal of Surgery Feb 2024
Topics: Humans; Malacoplakia; Neoplasm Recurrence, Local; Pelvis; Proctectomy; Perineum; Rectal Neoplasms; Postoperative Complications
PubMed: 37915265
DOI: 10.1111/ans.18753 -
Acta Medica Indonesiana Jul 2023Malakoplakia is a chronic granulomatous condition that has been rarely seen affecting the prostate. Isolated malakoplakia of the prostate occurring together with... (Review)
Review
Malakoplakia is a chronic granulomatous condition that has been rarely seen affecting the prostate. Isolated malakoplakia of the prostate occurring together with prostatic adenocarcinoma is rarer still with only 9 previously recorded cases. We present a case diagnosed through needle biopsy with prostatic adenocarcinoma and then on subsequent prostatectomy was diagnosed with extensive malakoplakia occurring with the carcinoma. Patient was noted to have a urinary tract infection (UTI) 2 weeks after needle biopsy and notably, 4 of the 9 previously reported cases also presented with UTI following their biopsies. The theory that prostatic malakoplakia may be a complication of the prostate needle biopsy is logically possible, but due to the paucity in cases, it is difficult to infer causality.
Topics: Male; Humans; Prostate; Prostatic Diseases; Malacoplakia; Prostatic Neoplasms; Adenocarcinoma
PubMed: 37915161
DOI: No ID Found -
QJM : Monthly Journal of the... Mar 2024
Topics: Humans; Urinary Bladder; Malacoplakia; Urinary Bladder Diseases
PubMed: 37847659
DOI: 10.1093/qjmed/hcad241 -
Transplant Infectious Disease : An... Dec 2023
Topics: Humans; Kidney Transplantation; Malacoplakia; Anti-Bacterial Agents; Immunosuppression Therapy; Hydronephrosis
PubMed: 37787406
DOI: 10.1111/tid.14158 -
Cirugia Espanola Mar 2024
Topics: Humans; Mucocele; Diagnosis, Differential; Malacoplakia; Appendix; Cecal Diseases
PubMed: 37730119
DOI: 10.1016/j.cireng.2023.09.001 -
Clinical Nuclear Medicine Oct 2023A 56-year-old man presented with a 2-month history of a mass in the right epididymo-testicular region, which exhibited heterogeneous high avidity for 18F-FDG on PET/CT....
A 56-year-old man presented with a 2-month history of a mass in the right epididymo-testicular region, which exhibited heterogeneous high avidity for 18F-FDG on PET/CT. Malignant tumor was highly suspected, leading to subsequent right orchiectomy and epididymectomy. Histopathological examination revealed the presence of characteristic Michaelis-Gutmann bodies within von Hansemann macrophages, confirming the diagnosis of malacoplakia.
Topics: Male; Humans; Middle Aged; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Malacoplakia; Testis; Positron-Emission Tomography
PubMed: 37682619
DOI: 10.1097/RLU.0000000000004799 -
Clinical Nuclear Medicine Oct 2023Malacoplakia is a rare chronic granulomatous disease and frequently associated with Escherichia coli infection. We describe the contrast-enhanced CT and FDG PET/CT...
Malacoplakia is a rare chronic granulomatous disease and frequently associated with Escherichia coli infection. We describe the contrast-enhanced CT and FDG PET/CT findings in a case of bladder and ureteral malakoplakia with E. coli urinary tract infection. Contrast-enhanced CT showed multiple enhancing mural nodules in the bladder and left ureter, ranging from several millimeters to 3.1 cm. The ureteral nodules showed significantly increased FDG uptake with SUVmax of 20.4, due to histiocyte, lymphocyte, and plasma cell infiltrates revealed by histopathology.
Topics: Humans; Ureter; Fluorodeoxyglucose F18; Malacoplakia; Escherichia coli; Positron Emission Tomography Computed Tomography; Ureteral Neoplasms
PubMed: 37682609
DOI: 10.1097/RLU.0000000000004800